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Acute abdomen (AA) is the term used to define a pathological condition that affects the abdominal cavity and frequently manifests itself with acute clinical symptoms capable of compromising a cow’s life. Therefore, it should be considered as an emergency that should be evaluated as quickly as possible to adopt the appropriate therapeutic measure (medical or surgical). In an AA situation, the clinician must consider the appropriate diagnostic approach as well as the therapeutic choice. Given the emergency, the veterinarian’s experience will be decisive for the appropriate resolution. In this article, we briefly review the causes that may lead to this condition, as well as the different diagnostic tests available in field conditions to establish the correct diagnosis and treatment.

Laparoskopinin uygulanılabilirliği, invaziv cerrahiye kıyasla noninvaziv cerrahinin etkileyici sonuçlarına bağlıdır. İnsanlarda uygulanılan birçok cerrahi işlem, etkin ve düşük morbidite nedeniyle veteriner hekimlikte de yer almaktadır. Veteriner hekimlikte karaciğer, ekstrahepatik biliyer sistem, pankreas, böbrekler, dalak, bağırsak ve genitoüriner sistem dahil olmak üzere çeşitli organların noninvazif değerlendirilmesi için birçok teknik geliştirilmiştir. Çalışma materyallerini, abdominal organlarda problem şühpeli ve travma öyküsü olan farklı cins, yaş, cinsiyet ve ağırlıktaki yirmi kedi oluşturdu. Klinik incelemelerin ardından olgulara laparoskopik cerrahi uygulandı. Klinik muayenede vakaların tamamı vital olarak stabildi. Laparoskopik incelemede karaciğer, safra kesesi, mide, böbrek, bağırsaklar, mesane, uterus ve dalak net olarak izlendi. Olguların tamamına yakınında herhangi bir patoloji ile karşılaşılmazken; bir olguda dalak renginde değişiklik gözlendi. Bazı olgularda kontrollü sistozentez uygulandı. Bu makale, kedilerde laparoskopi için gerekli ekipman ve tekniklerin gerekli olduğunu vurgulamaktadır. Laparoskopik muayenenin intraabdominal organların incelenmesinde veya patolojik kitlelere biyopsi uygulanmasında diğer yöntemlerine göre daha başarılı sonuçlar verdiği görülmektedir., The use of diagnostic and therapeutic laparoscopy has increased tremendously in human medicine in the last 10 years. The widespread acceptance of laparoscopy is due to technological advances in equipment and the impressive results of this noninvasive modality compared to invasive surgery. Many procedures performed in humans are accepted for veterinary medicine due to the convenience, efficiency, and low morbidity of many procedures. Techniques have been developed in veterinary medicine for noninvasive evaluation of various organs including the liver, extrahepatic biliary system, pancreas, kidneys, spleen, intestine, and genitourinary system. Biopsy procedures of these organs can be performed in most patients with minimal risk. Twenty cats of different breeds, ages, genders, and weights with abdominal complications and a history of trauma were used as study material. After the clinical examination of the patients, laparoscopic surgery was performed. Clinical examination revealed that the cases were stable. Liver, gall bladder, stomach, kidney, intestines, urinary bladder, ovary, and spleen were clearly observed during the laparoscopic examination. While almost all of the cases are not encountered with any pathology in the organs; It was observed comfortably that in one case the spleen color changed regardless of age. Laparoscopy enabled controlled cytosynthesis in some cases. This article reviews that the equipment and techniques should be required for performing laparoscopy in cats. As a result, it was concluded that laparoscopic examination yielded more successful results in the examination of abdominal organs or the application of surgical techniques on the biopsy of pathological masses compared to other diagnostic methods. Further studies with a larger group of cats should be considered to compare the efficacy of laparoscopic procedures.

Although the diseases of the abdomen in camels (Camelus dromedaries) are frequent than those of other systems, various abdominal disorders are passed misdiagnosed or detected incidentally at postmortem examination. This may be because of the large abdominal circumference in camels, and the nature of subacute abdominal pain even in severe conditions. By abdominal ultrasonography, the veterinarian can scan the rumen, reticulum, omasum, abomasum, and small and large intestines and peritoneum in camels. Samples of peritoneal fluid can also be collected under ultrasound guidance. Sonography has been used recently in camels for scanning of the healthy organs as well as evaluation and determining the diagnosis and prognosis of diseased ones. Examples of diseases evaluated by ultrasonography are pneumonia, pleurisy, splenic abscessation, hepatic disorders, nephrolithiasis, hydronephrosis, pyelonephritis, renal abscessation and renal neoplasms. Of the abdominal disorders diagnosed by ultrasonography are intestinal obstruction, volvulus, intussusception, abdominal effusions, peritonitis, abdominal and pelvic abscessations, chronic enteritis due to paratuberculosis, and neoplasia. In such cases, ultrasonography supplements the clinical and laboratory examinations by providing additional information on abdominal disorders for diagnosis antemortem. This review article is written to describe the results of abdominal ultrasonography in healthy camels as well as in camels with some abdominal disorders.

Made available in DSpace on 2021-07-14T10:42:25Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-06-18. Added 1 bitstream(s) on 2021-07-14T11:36:25Z : No. of bitstreams: 1 S0100-736X2021000100218.pdf: 1449659 bytes, checksum: 3e0fc8cfdd4f6e8857f51d763750a3b8 (MD5) Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Este estudo teve como objetivo avaliar a laparoscopia com exames de ultrassom abdominal para estabelecer um diagnóstico e prognóstico precisos. O desenho experimental foi um estudo clínico prospectivo. Nove bovinos adultos mestiços com distúrbios abdominais foram utilizados. Os bovinos admitidos na Clínica de Bovinos foram submetidos a exame clínico, adicionalmente foram realizadas hemograma e ultrassonografia abdominal. Posteriormente, foi realizada laparoscopia exploratória. Após a cirurgia (laparoscopia exploratória no lado direito ou esquerdo), nove animais com manifestações clínicas graves e intratáveis foram sacrificados e necropsiados. Durante a laparoscopia, não foi possível detectar reticuloperitonite circunscrita, bem como outras anormalidades na região crânio-ventral do abdome, previamente observadas na ultrassonografia e confirmadas durante a necropsia. No entanto, alterações devido a dano peritoneal, como aderências, foram observadas dorsalmente. É possível que a laparoscopia exploratória em apoio quadrupedal através da fossa paralombar constitua um procedimento complementar para o diagnóstico de distúrbios abdominais em bovinos, embora não seja adequado em casos de doenças caracterizadas por lesões focais concentradas na região cranioventral do abdome. Quando associada a exames clínicos, laboratoriais e de ultrassom, essa técnica pode melhorar o diagnóstico e prognóstico preciso dos distúrbios abdominais em bovinos. This study aimed to evaluate laparoscopy with abdominal ultrasound exams to establish accurate diagnosis and prognosis. The experimental design was a prospective clinical study. Nine adult crossbred bovines suffering from abdominal disorders were admitted to the cattle clinic for clinical examinations. Abdominal ultrasound was carried out, and complete blood counts were performed. Subsequently, exploratory laparoscopy was performed. After surgery (exploratory laparoscopy on the right or left side), animals with a severe prognosis or untreatable clinical condition were euthanised and necropsied. During laparoscopy, circumscribed reticuloperitonitis could not be detected, nor could other abnormalities in the cranioventral region of the abdomen previously observed on ultrasound and confirmed during necropsy. However, alterations due to peritoneal damage, such as adhesions, were observed dorsally in addition to alterations in macroscopic aspects of the peritoneal fluid. Exploratory standing laparoscopy through the paralumbar fossae may constitute a supplementary procedure for diagnosing abdominal disorders in cattle, but it is not suitable in cases of diseases characterised by focal lesions concentrated in the cranioventral region of the abdomen. When associated with clinical, laboratory, and ultrasound examinations, this technique may improve the accurate diagnosis and prognosis of abdominal disorders in cattle. Universidade Estadual Paulista, Faculdade de Medicina Veterinária e Zootecnia Universidade Federal Rural de Pernambuco, Clínica de Bovinos Universidade Estadual Paulista, Faculdade de Medicina Veterinária e Zootecnia FAPESP: 2016/20066-4

Illegal mining is a major public health and societal concern. Recent scientific evidence indicates elevated blood–lead levels in illegal gold miners and associated communities. Yet, there is little research in this regard from low- to middle-income countries (LMICs), where illegal mining is growing. This case series is extracted from a cross-sectional study of lead exposure in incarcerated juveniles in greater Johannesburg. From survey records (blood–lead levels and questionnaires), three males had elevated blood–lead levels and presented with health conditions and behavioural problems putatively linked with lead poisoning. Based on the record review, all three juveniles were in a secure facility due to illegal mining-related activities. All three cases had high blood–lead levels and demonstrated a tendency toward aggressive or violent behaviour. They also presented with conditions associated with lead poisoning, such as anaemia, respiratory illness, abdominal disorders, and musculoskeletal conditions. Juveniles involved in illegal mining are at risk of exposure to heavy metals such as lead, and there is a need for relevant preventative action and health care programmes in this group.

Background Functional abdominal pain disorders (FAPDs) are among the most common causes of consultation in general pediatrics and pediatric gastroenterology. The Rome IV criteria recommend testing for celiac disease (CD) in children with irritable bowel syndrome-diarrhea (IBS-D) and leaves testing in cases of other FAPDs to the practitioner's discretion. These recommendations were based on a single study that showed a 4-fold increase of CD among patients with IBS in Italy. It is unclear if these findings can be extrapolated to other populations. Understanding whether those results are reproducible in areas with different racial/ethnic backgrounds can optimize patient care. Aim The aim of the study was to assess the prevalence of CD in a sample of children consulting for FAPDs to a tertiary care center in Miami. Methods The charts of all pediatric patients consulting for FAPDs from January 2016 to November 2019 at the University of Miami were reviewed. Demographics, diagnosis, and CD testing for each child were analyzed. Results One hundred eighty-one children with FAPDs and celiac testing were seen. Mean age of 12.89 years, girls 61.34%. 84 (46.40%) had a diagnosis of IBS and 97 (53.59%) had a diagnosis of other FAPD. One of 181 children with FAPDs (0/84 with IBS and 1/97 with other FAPDs) had positive CD serological testing and EGD confirmation. Conclusions Our study suggests that the prevalence of CD among children with FAPDs is similar to the community prevalence. This data questions the benefit of testing all children FAPDS (including IBS) for CD. Studies with larger sample size and various racial/ethnic makeup should be done to confirm our findings.

Introduction The present study aims to compare low-kV CT reconstructed with MBIR technique with MRI in detecting high-risk stigmata and worrisome features in patients with pancreatic cystic lesions. Methods We retrospective enrolled 75 patients who underwent low-kV CT with contrast media injection for general abdominal disorders and MRI with MRCP sequences. The reviewer, blinded to clinical and histopathological data, recorded the overall number of pancreatic cystic lesions, size, location, presence of calcifications, septa, or solid enhancing or non-enhancing components, main pancreatic duct (MPD) communication, and MPD dilatation. Mean differences with 95% limits of agreement, ICC, and κ statistics were used to compare CT and MRI. Results More pancreatic cystic lesions were detected with MRI than with CT, however, the ICC value of 0.81 suggested a good agreement. According to the evaluated target lesion, a very good agreement (ICC = 0.98) was found regarding the diameter (21.4 mm CT vs 21.8 mm MRI), the location (κ = 0.90), the detection of MPD dilatation (κ = 1), the presence of septa (κ = 0.86) and the MPD communication (κ = 0.87). A moderate agreement on the assessment of enhanced components was noted (κ = 0.44), while there was only a fair agreement about the presence of calcifications (κ = 0.87). Conclusion MDCT can be considered almost equivalent to MRI with MRCP in the evaluation of worrisome features and high-risk stigmata, offering detailed morphologic features helpful for their characterization. Implications for practice Even if MRI is considered the reference standard in pancreatic cystic lesions characterization, CT can be considered a useful tool as a first-line imaging technique to identify worrisome features and high-risk stigmata.

Abdominal pathologies in equids are a source of major concern for both owners and veterinary practitioners. When a foal is involved, the situation is more complex because rectal examination is not possible. Abdominal ultrasonography can assist the diagnosis of a wide variety of abdominal disorders from uroperitoneum to colic. This article describes the normal ultrasonographic appearance of structures within the abdominal cavity and some of the pathologies that may arise.

Feeding intolerance, poor oral feeding skills, and retching are common symptoms seen in medically complex infants with a history of abdominal disorders and surgical interventions, such as gastrostomy tube placement and Nissen fundoplication. Visceral hyperalgesia may play a role in the underlying pathophysiology. We report the use of orally administered gabapentin in 3 infants with presumed visceral hyperalgesia presenting as poor tolerance of enteral and oral feeds. Retching and outward discomfort associated with feeds was resolved within 2 to 3 days of initiation of therapy. Full oral feeds were obtained in all 3 patients within 3 to 4 months of starting gabapentin without changing adjunctive medications or therapies. After attainment of full oral feeds, all patients were successfully weaned off gabapentin over a month, with no notable side effects, signs of withdrawal, or impact on ability to feed by mouth.

Ethnopharmacological relevance Historically, mangrove plants are among the potential sources of foods and remedies for humans living in the forests and nearby communities. Xylocarpus moluccensis (Lam.) M. Roem., an important mangrove medicinal plant, has been traditionally used for many purposes such as treatment of fever, dysentery, diarrhea, swelling, and abdominal disorders. The aim of the present work was to summarize the chemical reports and biological activities of the mangrove medicinal plant X. moluccensis based on information collected from different databases. Materials and methods An up-to-date search (till Aug 2019) was carried out in databases such as PubMed, Science Direct, Google Scholar, and various patient offices (e.g., WIPO, CIPO, USPTO) using the keywords: ‘Xylocarpus moluccensis’, and/or paired with ‘ethnobotanical use’, and ‘phytochemical’. In vitro, ex vivo, or in vivo studies were included. Results Findings suggest that X. moluccensis contains various important minerals and phytochemicals, where flavonoids, terpenes and terpenoids are the most prominent isolated phyto-constituents of X. moluccensis. Extracts/fractions or isolated compounds from this plant possess diverse biological activities, including anti-inflammatory, anti-microbial, antineoplastic, anti-diarrheal, insecticidal, anti-feedant, neuropharmacological (e.g., central nervous system depressant), anti-atherosclerotic, and lipid-lowering activity. Only one report suggests that the methanol and aqueous extracts of this plant did not exert cytotoxic effects on normal mouse fibroblast cells. However, no clinical studies were reported. Conclusions Taken all together, X. moluccensis may be one of the best sources of pharmacologically active lead compounds. More research, however, is necessary to establish the safety and efficacy, and its toxicogenetic effects in animal models.

In Ayurveda system of medicine, the root of Murva (Accepted source: Marsdenia tenacissima (Roxb.) Moon (Asclepiadaceae)) forms a vital component in various formulations like Ayaskrti, Brahanmanjistadi kvatha curna, etc. These formulations are indicated in the treatment of apasmara (epilepsy), hrdroga (cardiac disorders), mutra dosa (urinary disorders), kustha (skin diseases), pandu (anaemia), jvara (fever), netra roga (eye diseases) and gulma (abdominal disorders). But, there are several other plant species used in the name of Murva across the country and two such species are Sansevieria roxburghiana Schult. & Schult. f. (Agavaceae) and Bauhinia vahlii Wt. & Arn. (Caesalpiniaceae). Hence, in the present study, protective effect of ethanol and aqueous extract of S. roxburghiana rhizome and B. vahlli root was evaluated against Maximal Electrical Shock (MES) and Pentylenetetrazole (PTZ) induced convulsions in experimental animals.

Acute appendicitis is the most common cause of acute abdominal disorders requiring surgery. The mainstay of treatment is an appendectomy for more than 100 years. However, symptoms of acute appendicitis confuse many other conditions making diagnosis a challenge. In addition, as with all operations, postoperative complications exist, including wound infections, intra-abdominal abscesses, ileus and adhesions. For some specific patients (the first trimester of pregnancy or who have contraindications), surgery is not the best choice. So it is important to confirm if antibiotics-first approach is effective and may be used as an alternative treatment for appendectomy.

Wstęp: Appendektomia laparoskopowa przeprowadzana jest standardowo w znieczuleniu ogólnym. Przyjęto, iż taki rodzaj znieczulenia z towarzyszącym zwiotczeniem pacjenta jest najbardziej optymalnym sposobem, aby zapewnić wystarczającą przestrzeń operacyjną oraz odpowiedni efekt przeciwbólowy dla technik operacyjnych wymagających wytworzenia odmy otrzewnowej. Na podstawie doniesień w piśmiennictwie oraz przypadku opisanego w niniejszej pracy śmiało można stwierdzić, iż dotychczasowe podejście do znieczulenia w zabiegach laparoskopowych staje się coraz mniej uzasadnione.Omówienie przypadku: W pracy przedstawiono przypadek młodej, nieobciążonej internistycznie kobiety, u której rozpoznano ostre zapalenie wyrostka robaczkowego i którą zakwalifikowano do laparoskopowej appendektomii. Stopień ryzyka operacyjnego w skali Amerykańskiego Towarzystwa Anestezjologów (American Society of Anaesthesiology) oceniono na Ii zdecydowano o przeprowadzeniu zabiegu w znieczuleniu przewodowym. Zabieg i znieczulenie przebiegały bez komplikacji, jednocześnie chora uniknęła ryzyka potencjalnych powikłań wynikających ze znieczulenia ogólnego i zwiotczenia.Wyniki: Dzięki rozwojowi techniki operacyjnej oraz coraz większemu doświadczeniu operatorów wykonywane obecnie zabiegi laparoskopowe trwają znacznie krócej niż okres działania leków zwiotczających, a efekt przeciwbólowy znieczulenia przewodowego okazuje się zupełnie wystarczający. Ponadto omawiany przypadek chorej dowodzi, iż brak zwiotczenia w żaden sposób nie wpływa negatywnie na przebieg samego zabiegu.Wnioski: Leczenie operacyjne ostrego schorzenia jamy brzusznej metodą laparoskopową w znieczuleniu przewodowym jest wykonalne i bezpieczne u pacjenta bez istotnych obciążeń internistycznych. Przedstawiony w pracy przypadek chorej uzasadnia potrzebę szerszego stosowania tej metody znieczulenia w trakcie laparoskopowych operacji ostrych schorzeń jamy brzusznej, a ostateczna wartość znieczulenia przewodowego podczas zabiegów techniką laparoskopową powinna zostać określona na podstawie dalszych prospektywnych badań porównujących zastosowanie obu metod znieczulenia.

Functional abdominal pain disorders are highly prevalent in children. These disorders can be present in isolation or combined with organic diseases, such as celiac disease and inflammatory bowel diseases. Intestinal inflammation (infectious and non-infectious) predisposes children to the development of visceral hypersensitivity that can manifest as functional abdominal pain disorders, including irritable bowel syndrome. The new onset of irritable bowel syndrome symptoms in a patient with an underlying organic disease, such as inflammatory bowel disease, is clinically challenging, given that the same symptomatology may represent a flare-up of the inflammatory bowel disease or an overlapping functional abdominal pain disorder. Similarly, irritable bowel syndrome symptoms in a child previously diagnosed with celiac disease may occur due to poorly controlled celiac disease or the overlap with a functional abdominal pain disorder. There is little research on the overlap of functional abdominal disorders with organic diseases in children. Studies suggest that the overlap between functional abdominal pain disorders and inflammatory bowel disease is more common in adults than in children. The causes for these differences in prevalence are unknown. Only a handful of studies have been published on the overlap between celiac disease and functional abdominal pain disorders in children. The present article provides a review of the literature on the overlap between celiac disease, inflammatory bowel disease, and functional abdominal pain disorders in children and establish comparisons with studies conducted on adults.

Since antiquity, Alstonia scholaris commonly known as devil's tree or blackboard tree has been used for the treatment of many human ailments. The plant is used in Ayurvedic, Unani and Sidhha/Tamil types of alternative medicinal systems. Literature suggests that Alstonia scholaris is useful in treating malaria, abdominal disorders, dyspepsia, leprosy, skin diseases, tumors, chronic and foul ulcers, asthma, bronchitis etc. In order to validate these ethno-botanical practices the anti-inflammatory activity of methanolic extracts and various bioactive guided fractions of leaf of Saptparn (Alstonia scholaris, Apocyanaceae) tested. The anti-inflammatory activity of the extracts and its various fractions were evaluated using the carrageenan-induced rat paw edema method for the determination of acute phase of inflammation. Indomethacin used as reference drug. The result of pharmacological studies (anti-inflammatory) indicated the methanolic extract (200 mg/kg) significantly inhibited carrageenan induced rat paw edema in comparison to the inhibition of edema by standard drug Indomethacin (10mg/kg). Maximum inhibition of rat paw edema was observed with methanolic extract of plant (400 mg/kg) at the end of 4th hour when compared to control group. The chloroform fraction (50 mg/kg and 100 mg/kg) possess statistically significant anti-inflammatory activity. Maximum inhibition of rat paw edema was observed with chloroform fraction at 100 mg/kg at the end of 5th hour when compared to control group.

Objective To assess the added value of coronal reformatted images using 16-MDCT in different encountered non-traumatic-acute abdominal disorders. Patients and methods 16-MDCT was performed in 100 patients with acute non-traumatic abdominal pain. Two independent readers blinded to the clinical information interpreted the axial scans alone, and then axial plus coronal scans for the presence of pathology. Confidence was scored with a 1–5 scale (1 = absent, 5 = present). The final diagnosis was determined by surgical and pathologic reports and by clinical follow-up in those who did not undergo surgery. Results Mean sensitivity and specificity for the readers together were 92.5% and 92% for axial scans alone and 93.5% and 92.5% for combined axial and coronal scans (not significant), respectively. For the most inexperienced reader, the coronal reformations were helpful in 81% of cases, while for the most experienced reader, the coronal reformations were helpful in 39% of the cases. The coronal images were helpful in an average of 60% of the cases for the two readers. Conclusions Axial and coronal reformations of 16 slice MDCT have equal sensitivity and specificity for the diagnosis of acute abdominal pathology. However, coronal reformations improved the diagnostic confidence for all readers.

Aunque los tumores ováricos representan no más del 1 % de toda las neoformaciones en niñas menores de 16 años, ellos constituyen, sin embargo, el tumor genital más frecuente en ese período de la vida. A pesar de su rareza, ellos deberán tenerse en mente para el diagnóstico diferencial de muchos desórdenes abdominales. Debido a su poca frecuencia, algunas veces no son diagnosticados y pueden dar lugar a problemas especiales. Cualquier tipo de tumor ovárico visto en la mujer adulta, ha sido encontrado también en niñas. Aproximadamente el 30% de todos los tumores ováricos en niñas y adolescentes son teratomas quísticos o dermoides; el resto incluye toda clase de tumores benignos y malignos.

Berberis lycium belong to family Berberidaceae is an evergreen shrub growing in Himalayan region. The various parts of the plant like root, bark, stem, leaves and fruits are used by the people as a medicine or food. This plant has also gained wide acceptance for its medicinal value in ayurvedic drugs. The plant is known to prevent liver disorders, abdominal disorders, skin diseases, cough, ophthalmic etc. Moreover the pharmacological studies have shown that plant is hypoglycemic, hyperlipidemic, hepatoprotective, anticarcinogenic and antipyretic properties. The fruits of the plant are also very nutritious and are rich source of vitamins, minerals, antioxidants, anthocyanin etc. These fruits are consumed in raw form or are utilized in the preparation of juices, jams, preserve etc. by the local inhabitants. In the present article an attempt has been made to summarize the various properties of Berberis lycium plant.

Introduction: Pancreatitis is one of most complex and clinically challenging of all abdominal disorders. USG and abdominal CT are the most commonly used diagnostic imaging modalities for the evaluation of pancreas. Computed Tomography (CT) is highly accurate and sensitive than USG in both diagnosing as well as demonstrating the extent. Early assessment of the cause and severity of acute pancreatitis is of utmost importance for prompt treatment and close monitoring of patient with severe disease. CT is the imaging method of choice for assessing the extent of acute pancreatitis and for evaluating complications. Aim: To assess prognostic correlation and clinical outcome of acute pancreatitis on the basis of CT severity index. Materials and Methods: A prospective study of 50 cases was carried out in the Department of Radio Diagnosis, with complaint suggestive of acute pancreatitis on the basis of clinical/ laboratory/ultrasonography findings were evaluated in Siemens somatom 40 slice ct. The severity of pancreatitis was scored using CT severity index, modified severity index and revised Atlanta classification and classified into mild, moderate, severe categories. Clinical follow-up of the patients was done in terms of the following parameters: Length of hospital stay, Need for surgery or percutaneous intervention, Evidence of infection in any organ system, Occurrence of organ failure- respiratory, cardiovascular, renal, hepatic and haematological system, death. The clinical outcome was compared with the currently accepted Balthazar’s CTSI and Modified Mortele’s CTSI and revised Atlanta classification in all the cases. Results: Gall stone disease was most common aetiological factor seen in 40% cases, it was more common in females than males. Alcohol was second most common aetiological factor seen in 38% cases and was noted only in males. Pleural effusion was the most common extra-pancreatic complication seen in 46% cases. Balthazar grade C was the most common (40%) followed by grade D and E (25% each). Acute peripancreatic collection was the most common findings seen in 72% cases. Majority of the cases (42%) were categorized as mild pancreatitis according Balthazar CTSI score. Majority of the cases (44%) were categorized as severe pancreatitis according modified CTSI. Majority of the cases were categorized as mild pancreatitis according revised Atlanta classification. Organ system failure, death were more seen in severe grade in modified CTSI and revised Atlanta classification. Conclusion: Modified CT severity index makes the score easier to calculate and reduces the inter-observer variation. Scores obtained with the modified Mortele index, show a stronger statistical correlation for all clinical outcome parameters in all the patients better than the Balthazar index.

At the Clinic for Ruminants in Ljubljana, an investigation of peritoneal fluid in cows that stretched over 30 years was conducted. A total of 779 cows were studied; 444 had hardware disease, 212 had left abomasal displacement, 98 cows had right abomasal displacement with or without abomasal torsion, and 25 cows had problems with the uterus. Abdominocentesis, macroscopic and microscopic examination of peritoneal fluid (physical appearance, differantion to transudate/exudates, cytological characteristics) offered valuable diagnostic information. On the basis of the results of 779 laboratory examinations, we have come to the conclusion that abdominal fluid is of significant diagnostic, therapeutic and prognostic value for several acute and chronic abdominal diseases. .

BACKGROUND: Renal cell carcinoma appears in a certain percentage of patients combined with other abdominal disorders. Their simultaneous operative treatment is not widely reported in the literature. In this retrospective study, we have looked for the advantages of simultaneous operative procedures and whether these can be done safely in a primary surgical hospital. PATIENTS AND METHODS: From 1991-2007 we reviewed 14 cases. We compared the results with those of patients who underwent nephrectomy in our urological department and from the actual literature. RESULTS: The overall operation times in the combined surgical and the urological group were nearly identical (135 versus 131 min). The postoperative hospital stay was slightly longer in the combined surgical group (16.6 versus 13.3 days). The morbidity was higher in the combined surgical group. These patients had also a higher comorbidity. CONCLUSIONS: We can see clear advantages in simultaneous operations for renal cell carcinoma and other major surgical procedures in the abdomen. This study shows that an experienced surgeon in a primary surgical hospital can perform nephrectomy with simultaneous major abdominal procedures with advantages for the patient as far as operation time and hospital stay are concerned.

Ultrasound is widely used in small animal veterinary medicine for the investigation of cardiac disease and abdominal disorders. However, non-abdominal non-thoracic ultrasound in dogs and cats currently has a much more minor role in routine diagnostic work-ups. This article, based on a presentation given to the annual BMUS meeting in 2007, aims to provide some insight into the use of diagnostic ultrasound in evaluating the small parts of small patients.

Based on a routine ultrasonic screening program of patients suffering from acute abdominal disorders, the efficacy of ultrasonic diagnosis of intestinal obstruction was assessed prospectively in a series of 48 patients. In the entire series proven to suffer from ileus, all were correctly diagnosed prior to further procedures. In cases with marked gaseous distention, typical ultrasonic patterns were objectivated using a side position of the patients. The assessment of specific mucosal structures permitted the identification of the obstruction site in mechanical ileus. Sonographic observation in real time motion yielded a differential diagnosis of cases with persisting peristalsis and cases with complete paralysis. In 6 cases, causative diagnosis of ileus was achieved by sonography alone, in 12 cases by combination of clinical and sonographic findings.

Small-bowel obstruction (SBO) is a common clinical condition with signs and symptoms similar to other acute abdominal disorders. The radiologic investigation of patients with SBO as well as the indications and timing of surgical intervention have changed over the past 2 decades. This review focuses on modern imaging techniques and their role in both the diagnosis and treatment of patients with SBO.

Hepatic surface enhancement on CT can represent particular clinical significance in various abdominal conditions, at times being the only abnormality found. Detecting hepatic surface enhancement, together with the other ancillary diagnostic techniques as well, may lead to grasp of the underlying condition and to early or timely diagnosis and treatment of abdominal disorders. This manuscript describes the spectrum of hepatic surface enhancement on CT, and the importance of focusing on the hepatic surface during interpretation is emphasized.

Background: The activation peptide released from procarboxypeptidase B, CAPAP, is a marker of the activation of pancreatic enzymes in acute pancreatitis while anionic trypsinogen (AT) levels in urine relate to leakage of unactivated proenzymes. Data on these markers in patients suffering from severe acute abdominal disorders of non-pancreatic origin are lacking. Purpose: To examine levels of CAPAP and AT in serum and urine from patients with severe acute abdominal disorders of non-pancreatic origin in order to better define the diagnostic specificity of these two markers in severe acute pancreatitis in relation to other acute intra-abdominal disorders. Subjects and Methods: The study included 54 patients with severe acute abdominal disorders of non-pancreatic origin with an APACHE II score >3. Immunoreactive CAPAP (irCAPAP) and immunoreactive AT (irAT) were measured in serum and urine using specific immunoassays. Results: In urine, irCAPAP levels were mildly increased (>2 nmol/l) in 13% of the patients with severe acute abdominal diseases of non-pancreatic origin, but on no occasion did the increase approach the cutoff levels described for severe acute pancreatitis (>100 nmol/l). However, irAT levels in serum and urine were increased (>50 µg/l) in 54% of the cases. Conclusion: Contrary to what is found for irAT, patients with acute abdominal pain of non-pancreatic origin rarely have markedly increased levels of irCAPAP in serum and urine.

Sonography is frequently used as the first-line technology to evaluate patients with acute abdominal disorders as well as for the exploration of abnormalities of superficial structures. However, gas often interferes with sonographic examination. This illustrated article describes the spectrum of sonographic appearances of various abnormal location of gas collections as a key for definite diagnosis.

Zusammenfassung Die Besonderheiten in der hausarztlichen Praxis sind die Grundlage dieses Artikels. Vorangestellt sind die Red Flags, vom akutem Krankheitsbeginn und Schockzeichen bis zu Complianceproblemen, die ein sofortiges Handeln verlangen. Entsprechend den Gegebenheiten in der Praxis liegt der Fokus fur die Erstdiagnostik auf der manuellen und auskultatorischen Untersuchung des Abdomens, dem Notfalllabor und der sonographischen Untersuchung. Im Anschluss an die Auflistung der relevanten Differenzialdiagnosen wird speziell auf jene eingegangen, die eine Uberweisung in die Klinik erfordern. Handlungsorientiert sind die Masnahmen bis zum Eintreffen des RTW genannt, gefolgt von einer kritischen Analyse der therapeutischen Moglichkeiten und Grenzen in der hausarztlichen Praxis.

Introduction : Laparoscopy has proved to be an important tool in the minimally invasive exploration of selected patients with chronic abdominal disorders, whose diagnosis remains uncertain, despite exploring the requisite laboratory and imaging investigations like ultrasonography, computed tomography (CT) scan, and the like. Materials and Methods : Diagnostic Laparoscopy was conducted on 120 patients, admitted to the Departments of Surgery and Gynecology, Dayanand Medical College and Hospital, Ludhiana, with an uncertain diagnosis after four weeks of onset of symptoms. Conclusion : With laparoscopy providing tissue diagnosis, and helping to achieve the final diagnosis without any significant complication and less operative time, it can be safely concluded that diagnostic laparoscopy is a safe, quick, and effective adjunct to non‑surgical diagnostic modalities, for establishing a conclusive diagnosis, but whether it will replace imaging studies as a primary modality for diagnosis needs more evidence. Keywords : Chronic abdominal conditions, diagnostic laparoscopy, uncertain diagnosis

OBJECTIVE: Symptomatic gastroesophageal reflux disease (GERD), dyspepsia, and irritable bowel syndrome (IBS) are generally considered to be chronic conditions, but community-based studies are sparse, and long-term natural history data are unavailable. We aimed to determine the natural history of these conditions. METHODS: A representative Swedish sample (20–79 yr) completed a validated questionnaire over the preceding 3 months. The survey was repeated after 1 and 7 yr in the same target group (n = 1290, 1260, and 1065; response rates 90%, 87%, and 82%, respectively; 79% responded to all three mailings). RESULTS: The prevalence of GERD symptoms remained stable, whereas the prevalence of IBS increased over time, independent of aging. Dyspepsia decreased with advancing age. Although more than half of those with IBS reported the same symptom profile after 1 and 7 yr, there was a substantial symptom fluctuation and symptom profile flux between those reporting dyspepsia, IBS, or minor symptoms. Only a minority with GERD (

Background/Aims: Abdominal disorders occurring during pregnancy pose special difficulties in diagnosis and management to the obstetrician and surgeon. The advisability of nonobstetric abdominal surgery during pregnancy is uncertain. Our objective was to evaluate the safety and timing of abdominal surgery during pregnancy. Methods: We retrospectively reviewed 77 consecutive gravid patients undergoing nonobstetric abdominal surgery from 1989 to 1996 at an urban academic medical center and a large affiliated community teaching hospital. Medical records were evaluated for clinical presentation, perioperative management, preterm labor, and maternal and fetal morbidity and mortality. Results: The rate of nonobstetric abdominal surgery during pregnancy was 1 in every 527 births. Among the 77 patients, the indications for surgery were adnexal mass (42%), acute appendicitis (21%), gallstone disease (17%) and other (21%). There was no maternal or fetal loss or identifiable neonatal birth defect. Preterm labor occurred in 26% of the second-trimester patients and 82% of the third-trimester patients. Preterm labor was most common in patients with appendicitis and after adnexal surgery. Preterm delivery occurred in 16% of the patients, but appeared to be directly related to the abdominal surgery in only 5%. Conclusion: Surgery during the first or second trimester is not associated with significant preterm labor, fetal loss or risk of teratogenicity. Surgery during the third trimester is associated with preterm labor, but not fetal loss.

A portal vein aneurysm, first reported by Barzilai and Kleckner in 1956,1 is a rare clinical entity caused by portal hypertension or the malformation of veins. The frequent application of radiological imaging for diagnosis and screening of abdominal disorders accounts for the increasing number of case reports over the past 10 years; however, fewer than 60 cases have been reported in the English language literature to date. Herein we report a woman with an extrahepatic portal vein aneurysm, and present a review of literature relating to etiology, clinical significance and management strategies.

After a brief account of the origins of laparoscopy and of its development into an interventional technique thanks to technical improvement, the author gives a dynamic state of the art in laparoscopic surgery, beginning with a description of his original classification method for laparoscopic procedures according to their level of use. Before tackling the highly controversial issue of laparoscopic surgery for cancer, he reviews in detail the various operations successfully performed by laparoscopy for the treatment of nonmalignant abdominal disorders and acute syndromes, all the while checking their results against those obtained with their open counterparts. As the various procedures are described, the interest of the laparoscopic approach becomes clearly visible, based on the excellent view of the operative field that allows diagnostic accuracy, thus avoiding unnecessary operations, and precise dissection with minimal damage. However, the laparoscopic approach is highly dependent on the surgeon’s proficiency, itself depending on experience and therefore on the frequency of occurrence of the disorder, and on the progress in and availability of adequate equipments. The last chapter looks into the future of this ever-expanding approach and defines two great trends in its evolution, one accessible to the individual surgeon, the gradual adaptation of open procedures into laparoscopic ones, the other at the institutional level, in view of the huge financial support involved if high technologies are to be systematically integrated in this new surgery. What will the future be like?

Laparoscopic surgery is recognized as an established technique for several abdominal disorders. Aim of the present investigation was to assess the level of expertise of senior residents and to evaluate the role of the animal model on advanced laparoscopic training.Overall, 60 residents underwent a training session on a porcine model under the guidance of experienced laparoscopic surgeons. Of these, 30 residents underwent a box-trainer preparation before starting the surgical procedure on the animal model, while a group of 20 repeated the course 3 months after the first session. Global Operative Assessment of Laparoscopic Skills (GOALS) was used to evaluate technical proficiency.Senior residents presented low mean scores for all the GOALS domains for both for the minor and major surgical procedure. The box-trainer led to an improvement in suturing skills (P0.001). Comparison of the mean GOALS scores from the first to the second laparoscopic session demonstrated a significant improvement on the duration of the procedures (P0.05), onset of major complications (P=0.01), need of the tutor (P=0.08), and confidence in treating intraoperative bleeding (P=0.01).National Resident Training Programs should take into consideration the present quality of training and attempt to develop alternative methods of training for laparoscopic surgery, such as, the animal model laboratory.

In this study, 100 cattle were examined clinically and ultrasonographically in order to identify their abdominal disorders. The importance and advantages of ultrasonography were evaluated by testing the findings of radiography and abdominocentesis in suspicious cases. Examinations revealed that subjects were suffering from omphalitis (n = 30), extraumbilical abscess (n = 22), traumatic reticulitis (n = 14), urolithiasis and bladder rupture (n = 10), traumatic reticuloperitonitis (n = 6), hernia umbilicalis (n = 6), omphalophlebitis (n = 4), urachal fistula (n = 3), abomasum fistula (n = 2), hernia ventralis (n = 2) or ruminal fistula (n = 1). This investigation indicated that clinical symptoms were unspecific and insufficient for definitive diagnosis even though they provided valuable data at first. However, ultrasonography not only provided definitive results, but also dispelled doubts raised by techniques applied in previous or subsequent procedures., Stotinu goveda bilo je pretraženo klinički i ultrazvučno radi dokazivanja njihovih abdominalnih poremećaja. Važnost i prednosti ultrazvučne dijagnostike bili su procijenjeni na osnovi radiografskih nalaza i punkcije abdomena u sumnjivih slučajeva. Pretragom je bilo ustanovljeno da su goveda oboljela od omfalitisa (n = 30), izvanpupčanih apscesa (n = 22), traumatskog retikulitisa (n = 14), urolitijaze i prsnuća mokraćnog mjehura (n = 10), traumatskog retikuloperitonitisa (n = 6), pupčane hernije (n = 6), omfalofl ebitisa (n = 4), urahusne fistule (n = 3), fistule sirišta (n = 2), ventralne hernije (n = 2) ili buražnih fistula (n = 1). Istraživanje upućuje na zaključak da su klinički znakovi bili nespecifični i nedovoljni za postavljanje konačne dijagnoze, iako su u početku davali obećavajuće rezultate. Ultrazvučnom dijagnostikom potvrđeni su konačni nalazi i uklonjene sumnje postavljene pretragom metodama primijenjenima u prijašnjim ili naknadnim pretragama..

Traditional medicine system of India comprised varieties of plants which are playing a significant role in curing diseases from ancient times. Among them, Enicostemma littorale blume (E. littorale) a perennial herb of the family Gentianaceae is cosmopolitan in occurrence in India. The bittery natured plant acts as a laxative, helps in curing fever, rheumatism, skin diseases, abdominal disorders, snake bite, obesity and helps to regulate blood sugar levels. The plant constituents have been reported for possessing antimicrobial, antioxidant, antiulcer, antiinflammatory, hypolipidaemic, hepatoprotective and hypoglycemic properties. This review provides a bird's eye view about geographical distribution, physicochemical parameters, phytoconstituents and pharmacological properties of E. littorale.