EVALUATION OF THE EFFECTIVENESS OF COMBINING ANALGESICS AND ANTISPASMODICS IN THE MANAGEMENT OF ABDOMINAL PAIN IN URGENT SURGERY

Acute abdominal pain, a set of symptoms developing in patients having pathology of the gastrointestinal tract, abdominal cavity and retroperitoneal space, is known as one of the leading causes for surgical hospitalization both in Ukraine and abroad. The aim of this study was to evaluate the effects of a combination drug "Neospastil", which belongs to the group of antispasmodics in combination with analgesics, on the severity of symptoms of abdominal spastic pain in order to improve the treatment of patients. This clinical study included 90 patients with a clinical picture of abdominal pain syndrome, who were hospitalized to the surgical departments. The patients were divided into 3 groups, 30 patients in each. We used various options for antispasmodic and analgesic therapy and compared their effectiveness in terms of the time of the onset of the analgesic effect, the time period of relieving abdominal spasm, and the duration of the periods between repeated spastic pain attacks. The results of our study demonstrated the use of the combined drug "Neospastil" in the management of acute abdominal pain syndrome even in the first day enabled to reduce the severity of the pain syndrome by 38% compared with the drotaverine therapy and by 19% compared with analogues of the combined drugs. The period of the occurrence of subsequent spastic pains was prolonged with the study drug by 2.2 ± 0.5 hours compared with drotaverine and by 1.1 ± 0.1 hours compared with spasmalgon. When using “Neospastil”, a decrease in the duration of an attack of abdominal spasm was noted by 29% compared with drotaverine and by 22% compared with spasmalgon. Summarizing the obtained data, we can recommend the use of “Neospastil” for the primary therapy of abdominal spastic pain in surgical patients that will lead to an improvement in the clinical treatment outcomes.

Download Full-text

Unscheduled Revisits after Diagnosis of Abdominal Pain at Emergency Department, Mukdahan Hospital

Journal of the Medical Association of Thailand ◽

10.35755/jmedassocthai.2021.s01.12152 ◽

2021 ◽

Vol 104 (Suppl. 1) ◽

pp. S40-S43

Keyword(s):

Emergency Department ◽

Abdominal Pain ◽

Patient Care ◽

Acute Abdominal Pain ◽

Signs And Symptoms ◽

Discharge System ◽

Effective Discharge ◽

Time Period ◽

Pain Patients

Background: Abdominal pain is a common complaint for patients revisiting the Emergency Department (ED). Evaluating the cause of the revisit can improve the quality of ED patient care. Objective: We aimed to analyzed unscheduled revisits after diagnosis of abdominal pain at emergency department. Materials and Methods: In order to determine the characteristics of their abdominal pain and the causes for the revisits, the charts of 90 patients were reviewed. These patients had experienced acute abdominal pain and had returned to the Emergency Department within 48 hours after their initial treatment during the period between January 2019 and December 2019. Results: During that time period, 44,000 patients visited the ED. Of these, 90 patients (0.2%) with acute abdominal pain or related symptoms had revisited the ED within the following 48 hours. Most of these patients had been 20 to 60 years of age and had had no co-morbid diseases. Almost half of patient revisits had occurred during the evening shift (45.6%). There were 74% of these patients, who had been admitted to hospital for observation or for procedures. No in-hospital mortality was reported for this study. The signs and symptoms of abdominal pain in these patients had not been specific. The factors, which most often contributed to the ED revisits, had been inappropriate consultations and inappropriate discharges or advises. Conclusion: The majority of the acute abdominal pain patients, who revisited the ED within 48 hours, had been admitted. The most common cause of revisits had been inappropriate consultations and inappropriate discharges. Improving ED patient care can be managed by contributing to effective consultations and to establishing an effective discharge system for the ED. Keywords: Revisits, Emergency medicine department, Acute abdominal pain

Download Full-text

Midgut malrotation with volvulus - a case report

National Journal of Clinical Anatomy ◽

10.1055/s-0039-3401706 ◽

2013 ◽

Vol 02 (02) ◽

pp. 082-085

Author(s):

Pradipta Ray Choudhury ◽

Prasant Sarda ◽

Shobhit Singh ◽

Prabahita Baruah ◽

K. L. Talukdar

Keyword(s):

Abdominal Pain ◽

Mesenteric Artery ◽

Acute Abdominal Pain ◽

Abdominal Cavity ◽

Recurrent Abdominal Pain ◽

Midgut Malrotation ◽

Contrast Enhanced ◽

Whirlpool Sign ◽

Enhanced Computed Tomography ◽

Contrast Enhanced Computed Tomography

AbstractMidgut malrotation is a rare anatomic anomaly that complicates the diagnosis and management of acute abdominal pain. It is a congenital anomaly that arises from incomplete rotation or abnormal position of the midgut during embryonic development. A two years old boy was brought with recurrent abdominal pain and vomiting. On ultrasonography, the intestinal malrotation was suspected and thus contrast enhanced computed tomography (CECT) was done. On CECT, abnormal relationship between the superior mesenteric artery (SMA) and superior mesenteric vein (SMV), colon on the left side of the abdominal cavity, 'Whirlpool sign' etc., were found. All findings were suggestive of midgut malrotation with volvulus. Detection of uncomplicated malrotation should not be trivialized because such patients might experience a future complication.

Download Full-text

Hydatid cysts of the liver rupture into the peritoneal cavity: Fifteen cases and review of the literature

10.21203/rs.3.rs-151634/v1 ◽

2021 ◽

Author(s):

Atef MEJRI ◽

Khaoula ARFAOUI ◽

Sarra SAAD ◽

Jasser RCHIDI ◽

Ahmed OMRI ◽

...

Keyword(s):

Abdominal Pain ◽

Hydatid Cyst ◽

Peritoneal Cavity ◽

Cyst Wall ◽

Anaphylactic Shock ◽

Acute Abdominal Pain ◽

Abdominal Cavity ◽

Surgical Care ◽

Liver Hydatid Cyst ◽

The Mean

Abstract BackgroundHydatid cyst is an infectious disease caused mainly by E. Granulosus, which is generally considered benign, however, the rupture of the hepatic Hydatid Cyst to the abdominal cavity is a life-threatening incident that requires urgent and multidisciplinary management (emergency physician, radiologists, aneasthetists and surgeons). This study aims to describe the various clinical and paraclinical features of ruptured liver hydatid cyst in the peritoneal cavity, and to detail the appropriate treatment.Materials and MethodsFifteen cases of ruptured liver hydatid cyst into the abdominal cavity that underwent urgent surgery were collected over a period of eight years. Results There were nine men and six women. The average age was 38 years. Two patients were admitted with abdominal trauma. All patients presented with acute abdominal pain. Only one patient had anaphylactic shock. Abdominal ultrasound showed discontinuous cyst wall and intraperitoneal fluid in 100% of cases. Abdominal computed tomography (CT) showed discontinuous cyst wall with intraperitoneal fluid in 100% of cases. Intraoperatively, the intraperitoneal fluid was clear in thirteen cases and purulent in two. All patients underwent unroofing procedure associated with intra-operative peritoneal lavage and external drainage. The mean hospital stay was 6.11 days and the mean follow-up was 19 months. No case of recurrence was reported among the patients.ConclusionRupture of a hydatid cyst in the abdominal cavity should be considered as a differential diagnosis in every case of an acute abdominal pain, especially in endemic areas and in presence of an allergic reaction or signs of anaphylactic shock. Combined medical and surgical care starting in the emergency room is the only guarantee of a good outcome.

Download Full-text

ACUTE GASTRIC VOLVULUS WITH PERFORATION

Kuban Scientific Medical Bulletin ◽

10.25207/1608-6228-2018-25-3-173-177 ◽

2018 ◽

Vol 25 (3) ◽

pp. 173-177 ◽

Cited By ~ 1

Author(s):

I. H. SHIDAKOV ◽

B. M. KALNIYAZOV ◽

A. A. KARAEV

Keyword(s):

Abdominal Pain ◽

Clinical Case ◽

Acute Abdominal Pain ◽

Abdominal Cavity ◽

Gastric Lavage ◽

Gastric Volvulus ◽

Diagnostic Errors ◽

Underlying Disease ◽

Acute Gastric Volvulus ◽

Upper Gastrointestinal

Aim. To demonstrate a clinical case of acute gastric volvulus and to give a brief literary review of the disease. Materials and methods. A 12-year-old child who has applied for acute abdominal pain, repeated vomiting, with typical signs of obstruction of the upper gastrointestinal tract.Results. After the clinical and instrumental examination, the child was urgently operated. With laparotomy, the patient was diagnosed with acute secondary gastric volvulus with necrosis and perforation, against the background of a true left-sided diaphragmatic hernia, severe pancreatic lesions. The patient had a suturing of the stomach defect, diaphragm plastic, thorough sanitation and drainage of the abdominal cavity. The postoperative period was very difficult, due to complications of the underlying disease. As a result of the treatment, the patient was discharged in satisfactory condition.Conclusion. The clinical case confirms the severity of this nosology, accompanied by serious consequences. In our case, the patient recovered, but diagnostic errors and developing complications in acute gastric lavage often lead to death.

Download Full-text

CT in the diagnosis of nontraumatic acute abdominal pain: clinical cases

Medical Visualization ◽

10.24835/1607-0763-2019-2-82-89 ◽

2019 ◽

pp. 82-89

Author(s):

A. V. Arablinskii ◽

Yu. A. Magdebura

Keyword(s):

Abdominal Pain ◽

Ct Scan ◽

Acute Abdominal Pain ◽

Abdominal Cavity ◽

Selection Criterion ◽

Final Diagnosis ◽

Diagnostic Process ◽

Medical File ◽

Moscow City ◽

Ct Data

Acute abdominal pain (AAP) is a clinical symptom complex that develops with injuries and acute surgical diseases of the abdominal organs. This condition is one of the most frequent causes of admission of patients to the hospital through the ambulance. Patients with AAP consist of a large and heterogeneous group at the same time due to the etiology and many variations of the clinical picture of this condition. The article presents the results of CT scan of the abdominal cavity and small pelvis in 5 patients with AAP admitted to the S.P. Botkin Moscow City Clinical Hospital emergency department during 2017–2018, without indication of the possible traumatic nature of the pathology. All patients underwent a primary surgeon examination and first-line medical imaging methods such as plane radiography and ultrasound. The selection criterion for inclusion in the search was the need for CT due to the lack of data obtained for diagnosis. Subsequently, the findings of the CT scan were compared with the final diagnosis in the electronic medical file of the patient concerned, to assess the contribution of CT data to the diagnostic process. In a group of 5 patients included in the study, the results of CT were the decisive step in the diagnostic process in 100% of cases. Therefore, the study emphasizes the importance of using CT in patients with AAP. Using this method allows you to complete a diagnostic search as soon as possible from the time the patient enters the hospital, to begin timely treatment.

Download Full-text

CT imaging findings of epiploic appendagitis: an unusual cause of abdominal pain

Insights into Imaging ◽

10.1186/s13244-019-0715-9 ◽

2019 ◽

Vol 10 (1) ◽

Cited By ~ 8

Author(s):

Dario Giambelluca ◽

Roberto Cannella ◽

Giovanni Caruana ◽

Leonardo Salvaggio ◽

Emanuele Grassedonio ◽

...

Keyword(s):

Abdominal Pain ◽

Acute Abdominal Pain ◽

Acute Diverticulitis ◽

Abdominal Cavity ◽

Imaging Features ◽

Imaging Findings ◽

Hernia Sac ◽

Epiploic Appendagitis ◽

High Attenuation ◽

Epiploic Appendage

AbstractEpiploic appendagitis is a rare cause of acute abdominal pain, determined by a benign self-limiting inflammation of the epiploic appendages. It may manifest with heterogeneous clinical presentations, mimicking other more severe entities responsible of acute abdominal pain, such as acute diverticulitis or appendicitis. Given its importance as clinical mimicker, imaging plays a crucial role to avoid inaccurate diagnosis that may lead to unnecessary hospitalization, antibiotic therapy, and surgery. CT represents the gold standard technique for the evaluation of patients with indeterminate acute abdominal pain. Imaging findings include the presence of an oval lesion with fat-attenuation surrounded by a thin hyperdense rim on CT (“hyperattenuating ring sign”) abutting anteriorly the large bowel, usually associated with inflammation of the adjacent mesentery. A central high-attenuation focus within the fatty lesion (“central dot sign”) can sometimes be observed and is indicative of a central thrombosed vein within the inflamed epiploic appendage. Rarely, epiploic appendagitis may be located within a hernia sac or attached to the vermiform appendix. Chronically infarcted epiploic appendage may detach, appearing as an intraperitoneal loose calcified body in the abdominal cavity. In this review, we aim to provide an overview of the clinical presentation and key imaging features that may help the radiologist to make an accurate diagnosis and guide the clinical management of those patients.

Download Full-text

Hydatid Cysts of the Liver Rupture into the Peritoneal Cavity: Fifteen Cases and Review of the Literature

10.21203/rs.3.rs-165286/v1 ◽

2021 ◽

Author(s):

Atef MEJRI ◽

Khaoula ARFAOUI ◽

Sarra SAAD ◽

Jasser RCHIDI ◽

Ahmed OMRI ◽

...

Keyword(s):

Abdominal Pain ◽

Hydatid Cyst ◽

Peritoneal Cavity ◽

Anaphylactic Shock ◽

Acute Abdominal Pain ◽

Abdominal Cavity ◽

Liver Hydatid Cyst ◽

The Mean ◽

Hydatid Cyst Rupture ◽

Cyst Rupture

Abstract BackgroundHydatid cyst is a parasitic infection caused mainly by E. Granulosus, which is generally considered benign. However, the hepatic Hydatid Cyst rupture in the abdominal cavity is a life-threatening incident that requires urgent and multidisciplinary management (emergency physician, radiologists, anesthetists, and surgeons). This study describes clinical and paraclinical liver hydatid cyst rupture in the peritoneal cavity and details the appropriate treatment.Materials and MethodsFifteen liver hydatid cyst cases ruptured into the abdominal cavity that underwent urgent surgery were collected over eight years. Results There were nine men and six women. Patients' age ranged from 14 to 59 years, with an age average of 38 years. Two patients were admitted with abdominal trauma, and acute abdominal pain was the common consultation's reason. Only one patient had an anaphylactic shock. Both abdominal ultrasound and CT scan showed discontinuous cyst wall and intraperitoneal fluid in 100% of cases. Intraoperatively, the intraperitoneal effusion was clear in thirteen cases and purulent in two. All patients underwent unroofing procedure associated with intra-operative peritoneal lavage and external drainage. The mean hospital stay was 6.11 days, and the mean follow-up was 19 months. No case of recurrence was reported among the patients.ConclusionRupture of a hydatid cyst in the abdominal cavity should be evoked in front of acute abdominal pain, especially in endemic areas, and in the presence of an allergic reaction or anaphylactic shock signs. Combined surgical and medical care starting in the emergency room is the only guarantee of a good outcome.

Download Full-text

Internal hernia as one of the causes of abdominal pain

Clinical Practice ◽

10.17816/clinpract10227-35 ◽

2019 ◽

Vol 10 (2) ◽

pp. 27-35

Author(s):

V. M. Kitaev ◽

E. G. Koshelev ◽

O. V. Sokolova ◽

G. Yu. Belyaev ◽

A. A. Egorov ◽

...

Keyword(s):

Computed Tomography ◽

Abdominal Pain ◽

Abdominal Cavity ◽

Pain Syndrome ◽

Internal Hernias ◽

Diagnostic Difficulties ◽

Modern Classification ◽

Acute Small Bowel Obstruction ◽

Ct Data

Abdominal pain is often observed in clinical practice, causing diagnostic difficulties for doctors of different specialties. Internal hernias are a surgical pathology and may be the cause for the development of acute small bowel obstruction and the occurrence of pain. A modern classification of internal hernias is presented and their topographic-anatomical description is given. The analysis of the results of computed tomography (CT) scan of the abdominal cavity in 20 patients with an unidentified cause of abdominal pain was performed. According to the CT data, three patients had internal hernias that caused the development of pain syndrome. A pathological displacement of intestinal loops with partial disruption of intestinal permeability and curvature of the mesentery without critical disturbance of blood supply was demonstrated in 4 patients with abdominal pain. The findings suggest that CT may be the method of choice when examining patients with an unknown cause of abdominal pain syndrome.

Download Full-text

Comparative analysis of the results of computerized phonoenterography in patients with acute destructive appendicitis before surgery and in the postoperative period

I P Pavlov Russian Medical Biological Herald ◽

10.23888/pavlovj20173469-475 ◽

2017 ◽

Vol 25 (3) ◽

pp. 469-475

Author(s):

K. V. Philippova ◽

O. V. Zaitsev

Keyword(s):

Abdominal Pain ◽

Comparative Analysis ◽

Acute Appendicitis ◽

Postoperative Period ◽

Spectral Power ◽

Abdominal Cavity ◽

Pain Syndrome ◽

Acoustic Signals ◽

Early Postoperative Period ◽

Control Group

Using the method of computerized phonoenterography we made an analysis of motor-evacuation function of the gastrointestinal tract in 35 patients with acute destructive appendicitis before surgery and in the postoperative period and in 30 patients without abdominal pain syndrome and concomitant pathology of the organs of the abdominal cavity. The obtained results of computerized phonoenterography different in the group of patients with acute appendicitis before appendectomy in comparison with group of patients without acute abdominal pathology (control group). For patients after appendectomy statistically significant differences with the control group in the vast majority of bands wasn’t obtained. Given the fact that the densities of the spectral power of acoustic signals of the abdominal cavity to assess the motor-evacuation function of the intestine in these groups of patients, we showed a reduction of motor-evacuation function of the intestine in patients with acute destructive appendicitis before surgery in comparison with patients of control group and recover in the postoperative period. Thus, the method of computerized phonoenterography is advisable to apply for the diagnosis of lower motor function of the intestine in patients with acute appendicitis, and in the early postoperative period in patients with acute destructive appendicitis for monitoring recovery of intestinal motility.

Download Full-text

Acute Abdominal Pain in Children: Causes and Development Factors

Педиатрическая фармакология ◽

10.15690/pf.v14i1.1702 ◽

2017 ◽

Vol 14 (1) ◽

pp. 55-59

Author(s):

E. A. Romanova ◽

L. S. Namazova-Baranova ◽

E. Yu. Dyakonova ◽

A. Yu. Romanov ◽

K. S. Mezhidov ◽

...

Keyword(s):

Differential Diagnosis ◽

Abdominal Pain ◽

Primary Care Physicians ◽

Clinical Presentation ◽

Acute Abdominal Pain ◽

Prehospital Care ◽

Pain Syndrome ◽

Diagnostic Methods ◽

Problem Solution ◽

Technical Equipment

Currently differential diagnosis of acute abdominal pain syndrome in children at prehospital care units is vital and urgent problem which requires solution. Unfortunately, embarrassing mistakes are still followed by late or inadequate treatment and complications as a result. The problem solution requires both medical stuff alert and diagnosis algorithm revision and improvement. Improvement of technical equipment and availability of instrumental diagnostic methods at the out-hospital settings is a pressing need. The article provides a classification, detailed pathogenesis, and clinical presentation of acute abdominal pain in children under different nosologies (therapeutic and surgical). We considered the problem of adequate differential diagnosis of acute abdominal pain in children when the diagnostics is performed by primary care physicians and specialists of emergency medical services at the prehospital stage.

Download Full-text