THE ACUTE ABDOMEN : An Overview and Algorithms - 11/09/11
Résumé |
The acute abdomen remains a challenge to surgeons and other physicians. Abdominal pain is the most common cause for hospital admission in the United States.7 Since the term acute abdomen inherently implies a suddenness of onset, the clinical course of abdominal symptoms can range from minutes to hours to weeks. Furthermore, the acute abdomen can present as acute exacerbation of chronic problems, such as chronic pancreatitis, vascular insufficiency, metabolic abnormalities, or collagen vascular diseases. The term, acute abdomen, is often used synonymously for a condition that requires immediate operative intervention. Those patients, who require immediate operation, represent only a subset of patients with an acute abdomen. This article is devoted entirely to the discussion of the patient with an acute abdomen. It has been written with the intent of not rehashing what has already been discussed in literature regarding this topic, but to specifically address the question “Has anything changed?” The topics in this article range from bowel obstruction, with perforation and diffuse peritonitis, to ruptured abdominal aneurysms, to narcotic withdrawal, to hereditary Mediterranean fever. The techniques for management of the acute abdomen range from pharmacologic, to laparoscopic, to formal laparotomy. The authors would submit that although many of the basic principles in managing the patient with the acute abdomen have remained intact, a great deal about our understanding and management of these patients has changed.
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Vol 77 - N° 6
P. 1227-1243 - décembre 1997 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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