Abdominal Pain Mimics

Murali, N.; Hayek, Sahar Morkos El

doi:10.1016/j.emc.2021.07.003

Cited by 11 publications

(13 citation statements)

References 60 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In this study, one-third of cases had a preliminary missed diagnosis other than OT. These results match those observed in earlier studies finding that preoperative diagnosis for pediatric OT is difficult [ 24 , 25 ]. There are several possible explanations for this result.…”

Section: Discussionsupporting

confidence: 92%

Characteristics and Risk Factors for Ischemic Ovary Torsion in Children

et al. 2022

View full text Add to dashboard Cite

Identifying ischemic ovary as a complication of ovary torsion (OT) is a significant challenge in children. This study identified risk factors for ischemic OT among pediatric OT patients to prevent delayed treatment. This retrospective study included pediatric inpatients who underwent operation for OT over 20 years. We employed multivariable logistic regression to find the risk factors associated with ischemic OT. Among the 118 patients included in this study, 78 (66.1%) had ischemic OT. Patients with ischemic OT tended to be younger; had more frequent vomiting; and had elevated White blood cell (WBC), C-Reactive protein (CRP), and segments in comparison with non-ischemic OT patients. Multivariable regression showed increased odds of ischemic ovary torsion, associated with higher WBC (12.3 × 103/mm3 vs. 8.7 × 103/mm3, p < 0.001), CRP (50.4 mg/L vs. 8.4 mg/L, p < 0.001), and vomiting (55.1% vs. 25%, p = 0.002) than in non-ischemic patients. A receiver-operating characteristic (ROC) analysis indicated that patients with vomiting, leukocytosis, or CRP ≧ 40 mg/L were more likely to have ischemic OT (sensitivity, 92%; specificity, 54%; PPV, 79.6; NPV, 78.9%). Ischemic OT is common among pediatric OT patients. The presence of potential risk factors of vomiting, leukocytosis, and CRP more significant than 40 mg/L may assist clinicians in ensuring an expedited surgical treatment.

show abstract

Section: Discussionsupporting

confidence: 92%

Characteristics and Risk Factors for Ischemic Ovary Torsion in Children

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Digestive involvement (like abdominal pain, diarrhea, nausea, vomiting) during COVID-19 infection is reported in almost half of cases, typically after pulmonary symptoms [70,71]. These are caused by the fact that ACE2 receptors are located at the level of gastrointestinal system, and also at pancreas [72,73]. On the other hand, the clinical presentation of acute adrenal insufficiency includes hypotension, collapse, nausea, vomiting, abdominal pain, fever, lethargy, confusion, etc., which may mimic a COVID-19 infection with digestive presentation [73].…”

Section: Clinical Elementsmentioning

confidence: 99%

“…These are caused by the fact that ACE2 receptors are located at the level of gastrointestinal system, and also at pancreas [72,73]. On the other hand, the clinical presentation of acute adrenal insufficiency includes hypotension, collapse, nausea, vomiting, abdominal pain, fever, lethargy, confusion, etc., which may mimic a COVID-19 infection with digestive presentation [73]. However, an infection itself (of any type) may be the trigger of on acute form of primary adrenal failure [73].…”

Section: Clinical Elementsmentioning

confidence: 99%

“…On the other hand, the clinical presentation of acute adrenal insufficiency includes hypotension, collapse, nausea, vomiting, abdominal pain, fever, lethargy, confusion, etc., which may mimic a COVID-19 infection with digestive presentation [73]. However, an infection itself (of any type) may be the trigger of on acute form of primary adrenal failure [73]. The incidence of adrenal crisis in general population is 10/100 individuals-years (a mortality of 0.5/100 patient-years) [73].…”

Section: Clinical Elementsmentioning

confidence: 99%

“…However, an infection itself (of any type) may be the trigger of on acute form of primary adrenal failure [73]. The incidence of adrenal crisis in general population is 10/100 individuals-years (a mortality of 0.5/100 patient-years) [73]. Prompt recognition and adequate glucocorticoid therapy is lifesaving [73].…”

Section: Clinical Elementsmentioning

confidence: 99%

See 2 more Smart Citations

COVID-19 infection: from stress-related cortisol levels to adrenal glands infarction

Popescu

Terzea²,

Cârșote³

et al. 2022

Rom J Morphol Embryol

View full text Add to dashboard Cite

Cortisol is a key element in acute stress including a severe infection. However, in coronavirus-associated disease, 20% of subjects experience hypocortisolemia due to direct or immune damage of pituitary and adrenal glands. One extreme form of adrenal insufficiency is found in 2/3 of cases with viral and post-viral adrenal infarction (AI) (with/without adrenal hemorrhage) that is mostly associated with a severe coronavirus disease 2019 (COVID-19) infection; it requires prompt glucocorticoid intervention. Some reports are incidental findings at computed tomography (CT)/magnetic resonance imaging (MRI) scans for non-adrenal complications like pulmonary spreading and others are seen on post-mortem analysis. This is a review of PubMed-accessible, English papers focusing on AI in addition to the infection, between March 1, 2020 and November 1, 2021. Exclusion criteria were acute adrenal insufficiency without the histopathological (HP) and/or imaging report of adrenal enlargement, necrosis, etc., respective adrenal failure due to pituitary causes, or non-COVID-19-related adrenal events. We identified a total of 84 patients (different levels of statistical evidence), as follows: a retrospective study on 51 individuals, two post-mortem studies comprising nine, respectively 12 patients, a case series of five subjects, seven single-case reports. HP aspects include necrosis associated with ischemia, cortical lipid degeneration (+/-focal adrenalitis), and infarcts at the level of adrenal cortex, blood clot into vessels, acute fibrinoid necrosis in arterioles and capsules, as well as subendothelial vacuolization. Collateral potential contributors to adrenal damage are thrombotic events, coagulation anomalies, antiphospholipid syndrome, endothelial dysfunction, severe COVID-19 infection with multiorgan failure, etc. Clinical picture is variable from acute primary adrenal insufficiency to asymptomatic or mild evolution, even a retrospective diagnostic; it may be a part of long COVID-19 syndrome; glucocorticoid therapy for non-adrenal considerations might mask cortisol deficient status due to AI/hemorrhage. Despite its rarity, the COVID-19-associated AI/hemorrhage represents a challenging new chapter, a condition that is essential to be recognized due to its gravity since prompt intervention with glucocorticoid replacement is lifesaving.

show abstract

Acute abdominal pain due to atypical bilateral adrenal infarction in acute myeloid leukemia with alterations related to myelodysplasia: A case report

Hirata,

Tago,

Yamashita

et al. 2023

Clinical Case Reports

View full text Add to dashboard Cite

Key Clinical MessageAcute myeloid leukemia (AML) can cause acute abdomen following adrenal insufficiency or adrenal infarction. Therefore, when diffusely enlarged adrenal glands and adrenal insufficiency of unknown cause are seen in a patient presenting with acute abdomen, adrenal infarction due to AML, or other hematologic diseases should be ruled out.AbstractA 49‐year‐old man developed acute abdominal pain following adrenal insufficiency and was diagnosed with acute myeloid leukemia (AML) with myelodysplasia‐related changes. Because AML can cause acute abdominal pain due to adrenal infarction following adrenal insufficiency, a patient with these conditions should be ruled out adrenal infarction due to AML or other hematologic diseases.

show abstract

Abdominal Pain Mimics

Cited by 11 publications

References 60 publications

Characteristics and Risk Factors for Ischemic Ovary Torsion in Children

Characteristics and Risk Factors for Ischemic Ovary Torsion in Children

COVID-19 infection: from stress-related cortisol levels to adrenal glands infarction

Acute abdominal pain due to atypical bilateral adrenal infarction in acute myeloid leukemia with alterations related to myelodysplasia: A case report

Contact Info

Product

Resources

About