Presentation
The pain is usually constant and is often present for several days prior to presentation. Patients may also have nausea and vomiting. [medical-institution.com]
Simple descriptive statistics and tables were used to present results. [sciencedomain.org]
Since the advent of antibiotics, presentation has become milder and is now commonly seen in older adults. Patients now typically present with symptoms such as malaise, low-grade fever, weight loss, and RUQ pain [4]. [hindawi.com]
[…] is similarly variable, and patients may present with acute, subacute or chronic illness, each with different radiological findings. [radiopaedia.org]
Thus, presenting an unusual presentation of EPN as pneumoperitoneum and intra-abdominal wall abscess. [saudisurgj.org]
Entire Body System
- Fever
Patients generally present with fever and abdominal pain. [medical-institution.com]
The fever persisted despite treatment with intravenous antibiotics (Ceftriaxone and Amikacin) for 48 hours. [indianpediatrics.net]
Aspects Fever and Abdominal Pain [antimicrobe.org]
Treatment Principle Herb Formulas Points Clinical Manifestations Itching or tickling in the throat Cough with expectoration of thin, watery or frothy white sputum Chills with low grade fever Anhidrosis No thirst Headache Aversion to Wind Blocked and / [americandragon.com]
- Sepsis
Upper GI perforations (stomach, duodenum) are usually 'sterile', but cause chemical peritonitis Colonic perforations usually cause severe sepsis Any penetrating injury below the nipples can cause abdominal organ perforation Clinical Features Careful history [jjs.me.uk]
Peritonitis may be further complicated by ileus, sepsis, or abdominal compartment syndrome. Etiology Clinical features Peritonitis is considered a surgical emergency, as it may cause sepsis with shock and organ failure! [amboss.com]
severe sepsis and septic shock. [clinicaladvisor.com]
(generalized) (unspecified organism) A41.9 ICD-10-CM Diagnosis Code A41.9 Sepsis, unspecified organism 2016 2017 2018 2019 Billable/Specific Code Applicable To Septicemia NOS intra-abdominal K65.1 ICD-10-CM Codes Adjacent To K65.1 K64.0 First degree [icd10data.com]
- Weight Loss
Loss Part 7: Oncology and Hematology Part 8: Infectious Diseases Part 9: Terrorism and Clinical Medicine Part 10: Disorders of the Cardiovascular System Part 11: Disorders of the Respiratory System Part 12: Critical Care Medicine Part 13: Disorders of [accessmedicine.mhmedical.com]
Spiking fever, abdominal pain and tenderness (most often at the lower costal margin), and weight loss are common manifestations. [what-when-how.com]
— Gastroparesis – can present with nausea, vomiting, abdominal pain, early satiety, postprandial fullness, bloating, and, in severe cases, weight loss. The most common causes are idiopathic, diabetic, or postsurgical. [medical-institution.com]
Carcinoma of the caecum or ascending colon : there is usually an associated change in bowel habit, weight loss and rectal bleeding. [patient.info]
Other symptoms may include weight loss, malaise and diarrhoea. On physical exam RUQ tenderness, guarding, rebound tenderness, hepatomegaly and occasional jaundice can be appreciated. [bjmp.org]
- Malaise
Other symptoms may include weight loss, malaise and diarrhoea. On physical exam RUQ tenderness, guarding, rebound tenderness, hepatomegaly and occasional jaundice can be appreciated. [bjmp.org]
Symptoms are malaise, fever, and abdominal pain. Diagnosis is by CT. Treatment is with drainage, either surgical or percutaneous. Antibiotics are ancillary. [merckmanuals.com]
— Hepatitis – Patients with acute hepatitis (eg, from hepatitis A, alcohol, or medications) may have fatigue, malaise, nausea, vomiting, and anorexia in addition to right upper quadrant pain. [medical-institution.com]
- Severe Pain
This possibility should be kept in mind in all patients with acute severe upper abdominal pain. [research.ece.ncsu.edu]
Pain is severe, and is accompanied by marked anorexia, dusky or sallow complexion, and severe emaciation. Location of Mass : The specific visceral organ affected determines the location of the mass. [americandragon.com]
[…] anti-inflammatory drugs (care if there is risk of peptic ulcer disease) or opioids (if there is severe pain) are good analgesics. [patient.info]
(a) Contrast-enhanced CT scan obtained in a 24-year-old man with recurrent prostatic abscess, severe pain, and fever shows an abscess of the prostate gland (arrow). [pubs.rsna.org]
Peritoneal irritation causes moderate to severe pain that is aggravated by motion, forcing the patient to lay still. Bowel sounds are hypoactive or absent. There is voluntary and involuntary guarding and rebound tenderness. [antimicrobe.org]
Gastrointestinal
- Abdominal Pain
Unilateral lower abdominal pain. [medical-institution.com]
Be familiar with the differential diagnosis of abdominal pain based on symptoms and location of pain. Discuss the evaluation of acute abdominal pain. Distinguish surgical from medical abdominal pain. [pedsinreview.aappublications.org]
Keywords: Abdominal pain, Interdisciplinary treatment, Myofascial pain, Visceral pain. [scielo.br]
Aspects Fever and Abdominal Pain [antimicrobe.org]
Assessment of abdominal pain in children can be very difficult. Abdominal pain in pregnancy also causes problems because of distortion of the normal anatomy and stretching of structures by the gravid uterus. [patient.info]
- Nausea
Normal pregnancy discomforts (eg, breast tenderness, frequent urination, nausea) are sometimes present. [medical-institution.com]
Listen for key features on history: sudden onset of unilateral pelvic pain, sometimes radiating to the groin, often associated with nausea and vomiting. [cdemcurriculum.com]
Patients typically present with severe abdominal pain and guarding, as well as nausea and vomiting. In most cases, peritonitis constitutes a surgical emergency. [amboss.com]
CASE REPORT: A 36-year-old African American male with a history of chronic pancreatitis presented to the emergency department for abdominal pain in the epigastric area along with nausea, vomiting, diarrhoea, fever. [bjmp.org]
[…] article ; read more in our article on bowel perforation. epidemiology depends on the cause presentation history may depend on the location of the perforation severe and generalised abdominal pain (upper) gradual and localised pain (lower) anorexia, nausea [radiopaedia.org]
- Abdominal Tenderness
Physical examination may reveal lower abdominal tenderness. On pelvic exam, the patient may have adnexal tenderness or an adnexal mass. Fever is uncommon, and usually low-grade if present. [cdemcurriculum.com]
Tender and thickened adnexae by pelvic in PID. An irreducible incarcerated inguinal hernia. A tender RLQ mass by abdominal palpation or rectal exam appendiceal abscess. [research.ece.ncsu.edu]
Spiking fever, abdominal pain and tenderness (most often at the lower costal margin), and weight loss are common manifestations. [what-when-how.com]
Physical signs included abdominal tenderness 95.4% (166/174), cervical motion tenderness 32.2% (56/174), and adnexal tenderness 48.3% (84/174) ( Table 1 ). The mean WBC count was 16.1, and the mean neutrophil count was 13.4. [dovepress.com]
- Left Lower Quadrant Pain
The patient may complain of left upper abdominal, left chest wall, or left shoulder pain (ie, Kehr’s sign). LOWER abdominal pain differential diagnosis: Lower abdominal pain syndromes often cause pain in either or both lower quadrants. [medical-institution.com]
Left lower-quadrant pain: guidelines from the American College of Radiology appropriateness criteria. Am Fam Physician. 2010;82(7):766-70. [hopkinsguides.com]
This is promoted by the lodging of fecal material in a diverticulum with spread of inflammation to surrounding tissue, and is accompanied by left lower quadrant pain. [research.ece.ncsu.edu]
- Chronic Abdominal Pain
Laparoscopy in chronic abdominal pain patients shows abnormalities in 53% of cases 13,14. It is worth stressing that peritoneal adhesions are in general not related to chronic abdominal pain. [scielo.br]
— Pancreatitis – Both acute and chronic pancreatitis are associated with abdominal pain that often radiates to the back. [medical-institution.com]
In addition, patients who presented with abdominal pain were more likely to have a shorter duration of antibiotic treatment ( P -value =0.015) when compared with those who had no pain on admission. [dovepress.com]
Cardiovascular
- Tachycardia
[…] valve 肺動脈弁欠損症/肺動脈弁欠損 abuse 虐待/乱用 academic general pediatrician アカデミック総合小児科医 acalculia 失計算 acanthocyte 有棘赤血球 acanthocytosis 有棘赤血球増加症 acanthosis nigricans 黒色表皮腫 acardiac fetus 無心胎児 acatalasemia 無カタラーゼ血/無カタラーゼ血症 acatalasia 無カタラーゼ症 accelerated junctional tachycardia [jpeds.or.jp]
Clinical Features High spiking fevers Chills Tachycardia Tachypnoea Leukocytosis Localised abdominal pain Anorexia Delay in return of bowel function 13. [slideshare.net]
Diagnosis of peritonitis includes classic abdominal symptoms (diffuse pain, guarding, rebound tenderness, rigidity, usually accompanied by “toxic” systemic signs (fever, tachycardia, tachypnea, leukocytosis or left shift SIRS). [clinicaladvisor.com]
A serum lactate and blood cultures are essential if the woman is systemically unwell (pyrexia, tachycardia, increased respiratory rate). [obgyn.onlinelibrary.wiley.com]
- Hypotension
Sepsis definitions 24 Systemic inflammatory response syndrome (SIRS) a Severe sepsis Septic shock Temperature >38°C or SIRS + lactic acidosis or hypotension Severe sepsis + hypotension (despite adequate fluid resuscitation) Heart rate >90 bpm Respiratory [obgyn.onlinelibrary.wiley.com]
Patients with adrenal crisis may present with shock and hypotension. — Irritable bowel syndrome (IBS) – Present with chronic abdominal pain and altered bowel habits. — Constipation – Constipation may be associated with abdominal pain. [medical-institution.com]
However most patient will present with the classic triad of hypotension, a pulsating mass and back pain. Continuous leakage will lead to rupture into the peritoneal cavity and eventually death. [radiologyassistant.nl]
Norepinephrine can successfully increase blood pressure in patients who are septic and remain hypotensive following fluid resuscitation. Norepinephrine is effective to treat hypotension in septic shock patients. [wjes.biomedcentral.com]
The patient experienced abdominal pain and hypotension after undergoing the procedure. (a) Unenhanced CT scan shows a large left rectus sheath hematoma (arrow). [pubs.rsna.org]
Musculoskeletal
- Arthritis
Chronic septic arthritis and osteomyelitis in a prosthetic knee joint due to Clostridium difficile. Eur J Clin Microbiol Infect Dis 14, 599 –601. [jmm.microbiologyresearch.org]
[…] adynamia, syncope, adenomegalies, abdominal masses, nausea, vomiting, diarrhea, obstipation, abdominal distension, belching, pirosis, early satiety, postprandial fullness, anorexia, jaundice, choluria, acholia, pruritus, hematemesis, melena, enterorrhagia, arthritis [scielo.br]
Neurologic
- Headache
Treatment Principle Herb Formulas Points Clinical Manifestations Itching or tickling in the throat Cough with expectoration of thin, watery or frothy white sputum Chills with low grade fever Anhidrosis No thirst Headache Aversion to Wind Blocked and / [americandragon.com]
Synonym: cerebral abscess ; intracranial abscess Symptoms Symptoms may include headache, fever, vomiting, malaise, irritability, seizures, or paralysis. Treatment The usual treatment is chemotherapy. [medical-dictionary.thefreedictionary.com]
[…] satiety, postprandial fullness, anorexia, jaundice, choluria, acholia, pruritus, hematemesis, melena, enterorrhagia, arthritis, arthralgia, chest pain, urinary urgency, nighttime urination, dispareunia, dysmenorrhea, low back pain, dorsal pain, fatigue, headaches [scielo.br]
Workup
(See Workup, Computed Tomography.) Sequential, multiple organ failure is the main cause of death. [emedicine.medscape.com]
Others are more often subacute in nature (viral hepatitis) and workup can proceed along at a less critical pace. [antimicrobe.org]
X-Ray
- X-Ray Abnormal
Abscesses near the diaphragm may result in chest x-ray abnormalities such as ipsilateral pleural effusion, elevated or immobile hemidiaphragm, lower lobe infiltrates, and atelectasis. CBC and blood cultures should be done. [merckmanuals.com]
Serum
- Neutrophilia
Labs were significant for leukocytosis with predominant neutrophilia and elevated liver enzymes. CT abdomen with contrast revealed an 8.4 cm multiloculated right hepatic mass extending to the kidney. [hindawi.com]
Laboratory
- Leukocytosis
[…] vaginosis · IUD · RLQ, LLQ pain · Fever · Leukocytosis · Bimanual pelvic examination · Pelvic ultrasound · CT scan Endometritis · Pregnancy 13 · Suprapubic pain · Fever · Leukocytosis · Bimanual pelvic examination Pancreatic abscess · Pancreatitis · [antimicrobe.org]
Leukocytosis is present in most cases. Jaundice is infrequent, but the serum alkaline phosphatase level is elevated in almost all patients. [what-when-how.com]
On the fifth day of hospitalization, a repeat blood panel showed leukocytosis, and a blood culture showed methicillin-resistant coagulase negative staphylococci. An ultrasound abdomen showed a right anterior subphrenic abscess. [indianpediatrics.net]
DIAGNOSIS 27. 27 CLINICAL PICTURE Abdominal pain Anorexia, Nausea/Vomiting Loss of Appetite Fever (38-40 ºC) Abdominal distention and tenderness Hypoactive or faint bowl sounds Leukocytosis 28. 28 CLINICAL PICTURE Shallow Breaths Low [slideshare.net]
Patients may have a high temperature and there may also be other evidence of a viral infection - eg, enlarged submandibular lymph glands and leukocytosis. If laparotomy is performed, enlarged mesenteric lymph nodes will be apparent. [patient.info]
Treatment
Treatment Principle Herb Formulas Points Clinical Manifestations Itching or tickling in the throat Cough with expectoration of thin, watery or frothy white sputum Chills with low grade fever Anhidrosis No thirst Headache Aversion to Wind Blocked and / [americandragon.com]
[…] for treatment failure 32. [bjmp.org]
TREATMENT 47. 47 Treatment of Intra-abdominal Infections Combination of modalities: A. [slideshare.net]
Conclusion: Outcome in treatment of intra-abdominal abscess continue to be influenced by risk factors which we found from our studies to be late presentation to hospital, delay in diagnosis, and abdominal massage. [sciencedomain.org]
Prognosis
This distinction is not only important for helping to predict prognosis, but is also vital for some treatment decisions. [nature.com]
Treatment and prognosis Treatment depends on the location of the infection and severity of systemic symptoms. Intravenous antibiotics are usually required and care must be taken as the organism is resistant to many antibiotics. [radiopaedia.org]
A subphrenic abscess is usually secondary, with the primary disease process having a direct bearing on diagnosis, treatment and prognosis. [indianpediatrics.net]
Association of an intra-abdominal abscess with remote organ failure, postoperative anastomotic leakage, non-localization of the abscess within the peritoneal cavity and gastrointestinal perforation due to typhoid enteritis was found to portend poor prognosis [biomedsearch.com]
Untreated peritonitis is poor, usually resulting in death. With Tx, prognosis is variable, dependent on the underlying causes. 37. 37 Peritonitis 38. 38 Peritonitis 39. [slideshare.net]
Etiology
Based on the etiology, peritonitis may be classified as primary or secondary. Primary peritonitis usually occurs in patients with underlying ascites, whereas secondary peritonitis affects those with a preexisting acute abdominal disease. [amboss.com]
The most common etiologies in adults being postoperative adhesions, malignancy related (eg, from colorectal cancer), and complicated hernias. [medical-institution.com]
Complete Peer review History: http://www.sciencedomain.org/review-history/18370 Abstracts Aim: To determine the pattern of presentation, etiology, clinical features, and treatment outcome of intra-abdominal abscess in sub-urban Bayelsa Nigeria and suggest [sciencedomain.org]
Etiology Intra-abdominal abscesses are classified as intraperitoneal, retroperitoneal, or visceral (see table Intra-Abdominal Abscesses ). Many intra-abdominal abscesses develop after perforation of a hollow viscus or colonic cancer. [merckmanuals.com]
Epidemiology
"Population-based study of the epidemiology of and the risk factors for pyogenic liver abscess". Clin Gastroenterol Hepatol. 2 (11): 1032–8. PMID 15551257 . [wikidoc.org]
Reference article This is a summary article ; read more in our article on bowel perforation. epidemiology depends on the cause presentation history may depend on the location of the perforation severe and generalised abdominal pain (upper) gradual and [radiopaedia.org]
Subphrenic abscess: the new epidemiology. Arch Surg, 1977; 112: 934–6. [ots1.narod.ru]
"National epidemiology of cutaneous abscesses: 1996 to 2005". The American Journal of Emergency Medicine. 27 (3): 289–92. doi : 10.1016/j.ajem.2008.02.027. PMID 19328372. ^ a b c Elston, Dirk M. (2009). Infectious Diseases of the Skin. [en.wikipedia.org]
Pathophysiology
[…] location of the perforation severe and generalised abdominal pain (upper) gradual and localised pain (lower) anorexia, nausea and vomiting examination rigid abdomen and generalised tenderness guarding and rebound bowel sounds range from quiet to absent pathophysiology [radiopaedia.org]
Associated pathophysiologic effects may become life threatening or lead to extended periods of morbidity with prolonged hospitalization. [emedicine.medscape.com]
Pathophysiology 3 major defense mechanisms of peritoneal cavity Mechanical clearance via Diaphragmatic Lymphatics Phagocytosis and destruction of adherent bacteria Sequestration and walling off of bacteria, with delayed clearance 10. [slideshare.net]
To our knowledge this has never been reported in the literature and more work needs to be done to understand the pathophysiology of elevated pancreatic enzymes in the context of a liver abscess in a patient with a history of chronic pancreatitis. [bjmp.org]
Prevention
[…] peritonitis that occurs when bacteria contaminate the peritoneum as a result of spillage from an intraabdominal viscus Prevention of secondary peritonitis: -prophylaxis for: 1. GRAM - AEROBIC BACILLI 2. [quizlet.com]
Procedure The aim of the procedure is to drain the abscess, remove unhealthy tissues and ensure the cavity does not close to prevent abscess reformation. The wound is left open to heal (known as healing by secondary intention). [teachmesurgery.com]
[…] review History: http://www.sciencedomain.org/review-history/18370 Abstracts Aim: To determine the pattern of presentation, etiology, clinical features, and treatment outcome of intra-abdominal abscess in sub-urban Bayelsa Nigeria and suggest possible preventive [sciencedomain.org]
Suitability of the iliac crest as a site for harvest of autogenous bone grafts. 17257957 - Descending necrotizing mediastinitis treated with rapid sternotomy followed by vacuum-a... 23892537 - Pancreatic surgery. 23452747 - Novel oral anticoagulants for the prevention [biomedsearch.com]
[…] problem make arrangements to insert a central line to guide replacement Antibiotics are indicated - use local policies Continuing Management Laparotomy is usually indicated – inform theatre and anaesthetist Initial laparoscopy if experienced enough may prevent [jjs.me.uk]