The acute abdomen in spinal cord injury patients

Juler, George L.; Eltorai, Ibrahim M.

doi:10.1038/sc.1985.20

Cited by 35 publications

(37 citation statements)

References 8 publications

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“…The patient's bowel sounds increased at first, but then disappeared at the follow-up. This finding is similar to that of Juler et al 11 ; nevertheless, monitoring bowel sounds is useful in these cases.…”

Section: Discussionsupporting

confidence: 79%

“…Autonomic dysreflexia is one of the most common symptoms of acute abdomen. 11 In our patient series, only one patient had autonomic dysreflexia; this may be because most of our AAE patients were sensory intact. It should nevertheless be remembered that autonomic dysreflexia might be earliest symptom of AAE.…”

Section: Discussionmentioning

confidence: 98%

“…In a recent study, researchers have found that the most common and early finding of AAE was anorexia, but in our study only one patient had anorexia. 11 Persistent fever and associated abdominal discomfort may be the only findings of AAE. Fever and presence of leukocyturia in urine are often considered as the symptoms of urinary tract infections, and therefore need to be treated.…”

Section: Discussionmentioning

confidence: 99%

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Acute abdominal emergencies and spinal cord injury; our experiences: a retrospective clinical study

et al. 2014

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Study design: Retrospective review of medical notes. Objective: To describe clinical, laboratory and examination findings of acute abdominal emergencies (AAE) in Turkish patients with spinal cord injury (SCI) and to examine diagnosis and management of AAE in early stages. Setting: Inpatient rehabilitation unit of tertiary research hospital. Methods: The medical records of 237 SCI patients were reviewed. The SCI patients who were recruited in the study had been diagnosed with AAE and treated medically or surgically while they were inpatients at the rehabilitation clinic. Results: Nine out of 237 SCI patients had been diagnosed with one of the AAE. Three patients were AIS A, three patients were AIS B and three patients were AIS C. The most common AAE was acute cholecystitis; three patients were diagnosed with this. The others were single cases of intra-abdominal hemorrhage, intra-abdominal abscess, tuba-ovarian abscess, subileus, Crohn's disease and cholangitis. Three of the patients were treated with surgery and six were treated medically. The most common symptoms in patients were fever, abdominal pain and abdominal discomfort (four of AAE). Three patients had abdominal tenderness and abdominal distension. The expected findings of AAE, rebound and defense, were positive only in two patients. Conclusion: Gall bladder disease is a common cause of AAE. The classic symptoms and examination findings will usually not facilitate acute abdomen diagnosis in the SCI group, so we should be aware of patients' subjective complaints and when necessary use advanced imaging techniques immediately.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

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Acute abdominal emergencies and spinal cord injury; our experiences: a retrospective clinical study

et al. 2014

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“…3,4 We present herein the case of a cervical SCI patient found to have a small intestinal perforation, and describe our findings to help clinicians make an appropriate diagnosis and initiate early surgical treatment. …”

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confidence: 97%

Ileal Perforation in a Patient with High Spinal Cord Injury: Report of a Case

Matsuo¹,

Tokuyama²,

Hosono³

et al. 2004

Surgery Today

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Assessing abdominal complications in patients who have previously suffered high spinal cord injury is very difficult because the resultant loss of sensory, motor, and reflux function of the abdominal wall can mask the typical signs of acute abdomen such as tenderness, muscle rigidity, and peritoneal rebound pain. We recently diagnosed a small intestinal perforation in a 77-year-old man with a C6-7 spinal cord injury sustained 14 years earlier. The patient was correctly diagnosed as having an acute abdominal condition, despite palsy of abdominal wall sensation. An emergency laparotomy was done and a 40-cm length of affected ileum, about 180 cm distal to the Treitz ligament, including a 1-cm perforation, was resected, followed by an end-to-end anastomosis. We report this case to raise awareness of the need for appropriate diagnosis and early surgical treatment of abdominal complications in spinal-cord-injured patients.

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“…Below that level, patients can be regarded as having 'low' cord injuries. 6 In young healthy women with acute abdomen, the most common presenting symptom is pain, but the SCI patients may or may not have pain. Patients with high cord injuries have altered physiological response and loss of sensory, motor and reflex function.…”

Section: Discussionmentioning

confidence: 99%

A case of silent rupture of an ectopic pregnancy

2008

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Study design: Case report and review of literature. Objectives: To report a case of a woman with paraplegia who had ruptured ectopic pregnancy but presented with minimal non-specific symptoms and no clinical signs. A trans-vaginal scan confirmed the diagnosis and an emergency laprotomy was performed to save the patient's life. Setting: Regional spinal injury unit in North West England. Conclusion: The diagnosis of ruptured ectopic in spinal cord injury woman can be difficult due to the lack of classical signs and symptoms. Awareness and constant vigilance is required to detect the early signs. Clinicians looking after such women should have sound knowledge of nervous system diseases and their pathophysiology. There should be a high index of suspicion when managing such cases and a prompt surgical treatment should be initiated.

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The acute abdomen in spinal cord injury patients

Cited by 35 publications

References 8 publications

Acute abdominal emergencies and spinal cord injury; our experiences: a retrospective clinical study

Acute abdominal emergencies and spinal cord injury; our experiences: a retrospective clinical study

Ileal Perforation in a Patient with High Spinal Cord Injury: Report of a Case

A case of silent rupture of an ectopic pregnancy

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