Diagnosis of the Acute Abdomen in the Neurologically Stable Spinal Cord–Injured Patient. A Case Study

Sheridan, Robert

doi:10.1097/00004836-199212000-00012

Cited by 10 publications

(27 citation statements)

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“…For example, appendicitis left untreated may progress and ultimately require a more extensive exploration or resection Adjusted for appendectomy, upper GIT surgery, lower GIT surgery, ASA score, age, and BMI. 8 Adjusted for attending alone. 3 Adjusted for appendectomy, lower GIT surgery, and ASA score.…”

Section: Discussionmentioning

confidence: 99%

“…A retrospective study of 30 spinal cord injury patients with appendicitis calculated a mean duration of symptoms before admission of 4 days with an additional 2 days in the hospital before diagnosis. 8,9 In an acute cervical spine injury patient with abdominal distention and no other clinical signs or symptoms of injury, a several-day colonic perforation was discovered with the incidental finding of free air on routine chest x-ray. 2,5,7,8 These include a vague ''squeezing''sensation that was the cue for bowel obstruction with compromised bowel or chronic diarrhea associated with a carcinoid tumor.…”

Section: Disclosures Of Significant Relationships Withmentioning

confidence: 99%

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Paraplegic and quadriplegic patients undergoing emergency abdominal surgery

Benjamin

Haltmeier

Karamanos

et al. 2015

Journal of Trauma and Acute Care Surgery

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Section: Discussionmentioning

confidence: 99%

Section: Disclosures Of Significant Relationships Withmentioning

confidence: 99%

Paraplegic and quadriplegic patients undergoing emergency abdominal surgery

Benjamin

Haltmeier

Karamanos

et al. 2015

Journal of Trauma and Acute Care Surgery

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“…In fact, approximately 33% of SCI patients experience a significant delay in diagnosis due to neurological pathway disruptions. 7 In addition, Sheriden et al reviewed 145 paraplegic and tetraplegic SCI patients admitted to the University of Arizona hospitals between 1978 and 1987 with an acute abdomen. The review found that 21 patients had 22 episodes of acute or subacute abdominal problems.…”

Section: Discussionmentioning

confidence: 99%

An Occult Presentation of Appendicitis in a Patient with Tetraplegia

Zaremski

Jayawardena²,

Lew³

2010

American Journal of Physical Medicine &Amp; Rehabilitation

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A 26-yr-old man with a C4 American Spinal Injury Association impairment scale B spinal cord injury was admitted due to a left calf pressure ulcer. The patient's initial laboratory results and physical examination findings were unremarkable, except for a stage IV pressure ulcer. On day 7, the patient developed fever and leukocytosis. A complete culture workup performed did not yield abnormalities. A computed tomography scan of the abdomen and pelvis revealed retrocecal appendicitis with a retrocecal abscess containing an appendicolith. The abscess was drained percutaneously, and the patient was given a 6-wk course of intravenous antibiotics. The patient returned to the hospital 30 days later for an appendectomy. Typical signs of appendicitis can be masked in patients with a spinal cord injury. It is crucial to include appendicitis in the differential diagnosis of this population, even though the presentation is as nonspecific as fever and leukocytosis.

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“…A case series attempting to identify early indicators suggested anorexia, changes in micturition, higher lesions or leucocytosis as diagnostic aids . The need for complex radiological imaging for diagnosis is greater in this population …”

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confidence: 99%

“…1 The need for complex radiological imaging for diagnosis is greater in this population. 1,2 Benjamin et al conducted the first large-volume outcome analysis of acute abdomen in SCI patients. SCI patients typically present later, with more advanced disease, and have a significant delay in diagnosis.…”

mentioning

confidence: 99%