Abdomen, acute Health Dictionary

A type of disease or disorder having a sudden onset with severe symptoms, and generally a short or self-limited duration (such as a head cold or sprain). The opposite of CHRONIC.... acute

The lower part of the trunk. Above, and separated from it by the diaphragm, lies the thorax or chest, and below lies the PELVIS, generally described as a separate cavity though continuous with that of the abdomen. Behind are the SPINAL COLUMN and lower ribs, which come within a few inches of the iliac bones. At the sides the contained organs are protected by the iliac bones and down-sloping ribs, but in front the whole extent is protected only by soft tissues. The latter consist of the skin, a varying amount of fat, three layers of broad, ?at muscle, another layer of fat, and ?nally the smooth, thin PERITONEUM which lines the whole cavity. These soft tissues allow the necessary distension when food is taken into the STOMACH, and the various important movements of the organs associated with digestion. The shape of the abdomen varies; in children it may protrude considerably, though if this is too marked it may indicate disease. In healthy young adults it should be either slightly prominent or slightly indrawn, and should show the outline of the muscular layer, especially of the pair of muscles running vertically (recti), which are divided into four or ?ve sections by transverse lines. In older people fat is usually deposited on and inside the abdomen. In pregnancy the abdomen enlarges from the 12th week after conception as the FETUS in the UTERUS grows (see PREGNANCY AND LABOUR; ANTENATAL CARE).

Contents The principal contents of the abdominal cavity are the digestive organs, i.e. the stomach and INTESTINE, and the associated glands, the LIVER and PANCREAS. The position

of the stomach is above and to the left when the individual is lying down, but may be much lower when standing. The liver lies above and to the right, largely under cover of the ribs, and occupying the hollow of the diaphragm. The two KIDNEYS lie against the back wall on either side, protected by the last two ribs. From the kidneys run the URETERS, or urinary ducts, down along the back wall to the URINARY BLADDER in the pelvis. The pancreas lies across the spine between the kidneys, and on the upper end of each kidney is a suprarenal gland

(see ADRENAL GLANDS). The SPLEEN is positioned high up on the left and partly behind the stomach. The great blood vessels and nerves lie on the back wall, and the remainder of the space is taken up by the intestines or bowels (see INTESTINE). The large intestine lies in the ?anks on either side in front of the kidneys, crossing below the stomach from right to left, while the small intestine hangs from the back wall in coils which ?ll up the spaces between the other organs. Hanging down from the stomach in front of the bowels is the OMENTUM, or apron, containing much fat and helping to protect the bowels. In pregnancy the UTERUS, or womb, rises up from the pelvis into the abdomen as it increases in size, lifting the coils of the small intestine above it.

The PELVIS is the part of the abdomen within the bony pelvis (see BONE), and contains the rectum or end part of the intestine, the bladder, and in the male the PROSTATE GLAND; in the female the uterus, OVARIES, and FALLOPIAN TUBES.... abdomen

Inflammatory condition of the bronchial tubes caused by cold and damp or by a sudden change from a heated to a cold atmosphere. Other causes: viral or bacterial infection, irritating dust and fumes, colds which ‘go down to the chest’.

Symptoms: short dry cough, catarrh, wheezing, sensation of soreness in chest; temperature may be raised. Most cases run to a favourable conclusion but care is necessary with young children and the elderly. Repeated attacks may lead to a chronic condition.

Alternatives. Teas – Angelica, Holy Thistle, Elecampane leaves, Fenugreek seeds (decoction), Hyssop, Iceland Moss, Mouse Ear, Mullein, Nasturtium, Plantain, Wild Violet, Thyme, White Horehound, Wild Cherry bark (decoction), Lobelia, Liquorice, Boneset. With fever, add Elderflowers.

Tea. Formula. Equal parts: Wild Cherry bark, Mullein, Thyme. Mix. 1 heaped teaspoon to cup water simmered 5 minutes in closed vessel. 1 cup 2-3 times daily. A pinch of Cayenne assists action.

Irish Moss (Carragheen) – 1 teaspoon to cup water gently simmered 20 minutes. It gels into a viscous mass. Cannot be strained. Add honey and eat with a spoon, as desired.

Tablets/capsules. Iceland Moss. Lobelia. Garlic. Slippery Elm.

Prescription No 1. Morning and evening and when necessary. Thyme 2; Lungwort 2; Lobelia 1. OR Prescription No 2. Morning and evening and when necessary. Iceland Moss 2; Wild Cherry bark 1; Thyme 2.

Doses:– Powders: one-third teaspoon (500mg) or two 00 capsules. Liquid Extracts: 30-60 drops. Tinctures: 1-2 teaspoons.

Practitioner. Alternatives:–

(1) Tincture Ipecacuanha BP (1973). Dose, 0.25-1ml.

(2) Tincture Grindelia BPC (1949). Dose, 0.6-1.2ml.

(3) Tincture Belladonna BP (1980). Dose, 0.5-2ml.

Black Forest Tea (traditional). Equal parts: White Horehound, Elderflowers and Vervain. One teaspoon to each cup boiling water; infuse 5-15 minutes; drink freely.

Topical. Chest rub: Olbas oil, Camphorated oil. Aromatherapy oils:– Angelica, Elecampane, Mullein, Cajeput, Lemon, Eucalyptus, Lavender, Mint, Onion, Pine, Thyme.

Aromatherapy inhalants: Oils of Pine, Peppermint and Hyssop. 5 drops of each to bowl of hot water.

Inhale: head covered with a towel to trap steam.

Diet: Low salt, low fat, high fibre. Halibut liver oil. Wholefoods. Avoid all dairy products. Supplements. Vitamins A, C, D, E. ... bronchitis, acute

Care that is generally provided for a short period of time to treat a new illness or a flare-up of an existing condition. This type of care may include treatment at home, short-term hospital stays, professional care, surgery, X-rays and scans, as well as emergency medical services.... acute care / acute health care

A disease which is characterized by a single or repeated episode of relatively rapid onset and short duration from which the patient usually returns to his/her normal or previous state or level of activity. An acute episode of a chronic disease (for example, an episode of diabetic coma in a patient with diabetes) is often treated as an acute disease.... acute disease / illness

See ALTE.... acute life-threatening event (alte)

Formerly known as adult respiratory distress syndrome. A form of acute respiratory failure in which a variety of di?erent disorders give rise to lung injury by what is thought to be a common pathway. The condition has a high mortality rate (about 70 per cent); it is a complex clinical problem in which a disproportionate immunological response plays a major role. (See IMMUNITY.)

The exact trigger is unknown, but it is thought that, whatever the stimulus, chemical mediators produced by cells of the immune system or elsewhere in the body spread and sustain an in?ammatory reaction. Cascade mechanisms with multiple interactions are provoked. CYTOTOXIC substances (which damage or kill cells) such as oxygen-free radicals and PROTEASE damage the alveolar capillary membranes (see ALVEOLUS). Once this happens, protein-rich ?uid leaks into the alveoli and interstitial spaces. SURFACTANT is also lost. This impairs the exchange of oxygen and carbon dioxide in the lungs and gives rise to the clinical and pathological picture of acute respiratory failure.

The typical patient with ARDS has rapidly worsening hypoxaemia (lack of oxygen in the blood), often requiring mechanical ventilation. There are all the signs of respiratory failure (see TACHYPNOEA; TACHYCARDIA; CYANOSIS), although the chest may be clear apart from a few crackles. Radiographs show bilateral, patchy, peripheral shadowing. Blood gases will show a low PaO2 (concentration of oxygen in arterial blood) and usually a high PaCO2 (concentration of carbon dioxide in arterial blood). The lungs are ‘sti?’ – they are less e?ective because of the loss of surfactant and the PULMONARY OEDEMA.

Causes The causes of ARDS may be broadly divided into the following:... acute respiratory distress syndrome (ards)

See “transitional care”.... post-acute care

Inefficient functioning of the kidney, leading to death unless acute medical attention is available. Envenomation (especially snake bite) is a common cause, as well as a range of medical conditions, including infection..... renal failure (acute)

See SARS.... severe acute respiratory syndrome (sars)

Sub-acute care is a bridge between acute care and home care. It is medical and skilled nursing services provided to persons who are not in the acute phase of an illness but who require a level of care higher than that provided in a long-term care setting.... sub-acute care

See under STOMACH, DISEASES OF; INTESTINE, DISEASES OF; DIARRHOEA; LIVER, DISEASES OF; PANCREAS, DISEASES OF; GALL-BLADDER, DISEASES OF; KIDNEYS, DISEASES OF; URINARY BLADDER, DISEASES OF; HERNIA; PERITONITIS; APPENDICITIS; TUMOUR.

Various processes that can occur include in?ammation, ulceration, infection or tumour. Abdominal disease may be of rapid onset, described as acute, or more long-term when it is termed chronic.

An ‘acute abdomen’ is most commonly caused by peritonitis – in?ammation of the membrane that lines the abdomen. If any structure in the abdomen gets in?amed, peritonitis may result. Causes include injury, in?ammation of the Fallopian tubes (SALPINGITIS), and intestinal disorders such as APPENDICITIS, CROHN’S DISEASE, DIVERTICULITIS or a perforated PEPTIC ULCER. Disorders of the GALLBLADDER or URINARY TRACT may also result in acute abdominal pain.

General symptoms of abdominal disease include:

Pain This is usually ill-de?ned but can be very unpleasant, and is termed visceral pain. Pain is initially felt near the mid line of the abdomen. Generally, abdominal pain felt high up in the mid line originates from the stomach and duodenum. Pain that is felt around the umbilicus arises from the small intestine, appendix and ?rst part of the large bowel, and low mid-line pain comes from the rest of the large bowel. If the diseased organ secondarily in?ames or infects the lining of the abdominal wall – the PERITONEUM – peritonitis occurs and the pain becomes more de?ned and quite severe, with local tenderness over the site of the diseased organ itself. Hence the pain of appendicitis begins as a vague mid-line pain, and only later moves over to the right iliac fossa, when the in?amed appendix has caused localised peritonitis. PERFORATION of one of the hollow organs in the abdomen – for example, a ruptured appendix or a gastric or duodenal ulcer (see STOMACH, DISEASES OF) eroding the wall of the gut – usually causes peritonitis with resulting severe pain.

The character of the pain is also important. It may be constant, as occurs in in?ammatory diseases and infections, or colicky (intermittent) as in intestinal obstruction.

Swelling The commonest cause of abdominal swelling in women is pregnancy. In disease, swelling may be due to the accumulation of trapped intestinal contents within the bowel, the presence of free ?uid (ascites) within the abdomen, or enlargement of one or more of the abdominal organs due to benign causes or tumour.

Constipation is the infrequent or incomplete passage of FAECES; sometimes only ?atus can be passed and, rarely, no bowel movements occur (see main entry for CONSTIPATION). It is often associated with abdominal swelling. In intestinal obstruction, the onset of symptoms is usually rapid with complete constipation and severe, colicky pain. In chronic constipation, the symptoms occur more gradually.

Nausea and vomiting may be due to irritation of the stomach, or to intestinal obstruction when it may be particularly foul and persistent. There are also important non-abdominal causes, such as in response to severe pain or motion sickness.

Diarrhoea is most commonly due to simple and self-limiting infection, such as food poisoning, but may also indicate serious disease, especially if it is persistent or contains blood (see main entry for DIARRHOEA).

Jaundice is a yellow discoloration of the skin and eyes, and may be due to disease in the liver or bile ducts (see main entry for JAUNDICE).

Diagnosis and treatment Abdominal diseases are often di?cult to diagnose because of the multiplicity of the organs contained within the abdomen, their inconstant position and the vagueness of some of the symptoms. Correct diagnosis usually requires experience, often supplemented by specialised investigations such as ULTRASOUND. For this reason sufferers should obtain medical advice at an early stage, particularly if the symptoms are severe, persistent, recurrent, or resistant to simple remedies.... abdomen, diseases of

Following accident render first-aid treatment. See: FIRST AID. Straining to lift a heavy weight or when at stool may force an intestinal loop through the muscular wall to produce a rupture. Severe cases of injury require hospitalisation; those from blows or bruising benefit from a cold compress of Comfrey root or Fenugreek seed.

Before the doctor comes: 3 drops each or any one: Tinctures Arnica, Calendula and Hypericum; hourly. ... abdomen, injuries

Glomerulonephritis. Recognised by slight puffiness of the eyes and a dropsical accumulation of fluid in body cavities. Blood pressure rises. Appetite disappears. Digestion is deranged, urine may be blood-stained and a variety of symptoms present as dizziness, headache, nausea. Commonly caused by post streptococcal throat infection circulating in the blood, yet it is now known that the condition may arise from exposure to common garden insecticides and toxic substances of commercial importance that alter the body’s immune system and affect kidney function.

Acute toxic nephritis is possible in the convalescent stage of scarlet and other infectious fevers, even influenza. Causes are legion, including septic conditions in the ear, nose, throat, tonsils, teeth or elsewhere. Resistance to other infections will be low because of accumulation of toxins awaiting elimination. When protein escapes from the body through faulty kidneys general health suffers.

This condition should be treated by or in liaison with a qualified medical practitioner.

Treatment. Bedrest essential, with electric blanket or hot water bottle. Attention to bowels; a timely laxative also assists elimination of excessive fluid. Diuretics. Diaphoretics. Abundant drinks of bottled water or herb teas (3-5 pints daily). Alkaline drinks have a healing effect upon the kidneys. Juniper is never given for active inflammation.

Useful teas. Buchu, Cornsilk, Couchgrass, Clivers, Bearberry, Elderflowers, Marshmallow, Mullein, Marigold flowers, Wild Carrot, Yarrow.

Greece: traditional tea: equal parts, Agrimony, Bearberry, Couchgrass, Pellitory.

Powders. Equal parts: Dandelion, Cornsilk, Mullein. Dose: 750mg (three 00 capsules or half teaspoon) every 2 hours. In water or cup of Cornsilk tea.

Tinctures. Equal parts: Buchu, Elderflowers, Yarrow. Mix. Dose: 1-2 teaspoons in water or cup of Cornsilk tea, every two hours.

Topical. Hot poultices to small of the back; flannel or other suitable material saturated with an infusion of Elderflowers, Goldenrod, Horsetail or Yarrow. Herbal treatment offers a supportive role. ... bright’s disease (acute)

Necrosis. Fatal disease in which the substance of the liver is destroyed. Incidence is rare since the public has been alerted to the dangers of certain chemical toxins, fumes from synthetic glues, solvents, and poisonous fungi.

Symptoms: jaundice, delirium and convulsions.

As it is the work of the liver to neutralise incoming poisons it may suffer unfair wear and tear, alcohol and caffeine being common offenders.

Treatment for relief of symptoms only: same as for abscess of the liver.

Treatment by or in liaison with a general medical practitioner. ... liver – acute yellow atrophy

 Inflammation of the vocal cords. May be associated with the common cold, influenza, and other viral or bacterial infections.

Causes: smoking, mis-use of the voice in talking or singing (Ginseng).

Symptoms: voice husky or absent (aphonia). Talking causes pain. Self-limiting.

Treatment. Stop talking for 2 days. Care is necessary: neglect or ineffective treatment may rouse infection and invade the windpipe and bronchi resulting in croup.

Differential: croup is alerted by high fever and characteristic cough, requiring hospital treatment. Alternatives. Teas: Red Sage. Garden Sage. Thyme, wild or garden.

Effective combination: equal parts, Sage and Raspberry leaves. Used also as a gargle.

Tablets/capsules. Poke root. Lobelia. Iceland Moss.

Cinnamon. Tincture, essence or oil of: 3-5 drops in teaspoon honey.

Horseradish. 1oz freshly scraped root to steep in cold water for two hours. Add 2 teaspoons runny honey. Dose: 2-3 teaspoons every two hours.

Topical. Equal parts water/cider vinegar cold pack round throat. Renew when dry.

Traditional: “Rub soles of the feet with Garlic and lard well-beaten together, overnight. Hoarseness gone in the morning.” (John Wesley) Friar’s balsam.

Aromatherapy. Steam inhalations. Oils: Bergamot, Eucalyptus, Niaouli, Geranium, Lavender, Sandalwood.

Diet. Three-day fruit fast.

Supplements. Daily. Vitamin A (7500iu). Vitamin C (1 gram thrice daily). Beta carotene 200,000iu. Zinc 25mg. ... laryngitis, acute

Inflammation of the liver from virus infection. As the commonest form of liver disorder, it is often without jaundice or marked liver symptoms apart from general malaise and abdominal discomfort, ‘Gippy tummy’, ‘chill on the liver’. For feverishness, add a diaphoretic.

Treatment. Bitter herbs keep the bile fluid and flowing.

Alternatives. Teas. Agrimony, Lemon Balm, Boldo, Bogbean, Centuary, Dandelion, Hyssop, Motherwort, Wormwood, Yarrow.

Maria Treben. Equal parts: Bedstraw, Agrimony, Woodruff. 2 teaspoons to cup boiling water.

Cold tea: 2 teaspoons Barberry bark to each cup cold water. Infuse overnight. Half-1 cup freely. Tablets/capsules: Blue Flag. Dandelion. Wild Yam. Liquorice.

Formula. Equal parts: Turkey Rhubarb, Dandelion, Meadowsweet. Dose: Liquid Extracts: 1-2 teaspoons. Tinctures: 2-3 teaspoons. Powders: 500mg (two 00 capsules or one-third teaspoon). 3-4 times daily. Alfred Vogel. Dandelion, Devil’s Claw, Artichoke.

Antonius Musa, physician to Emperor Augustus Caesar records: “Wood Betony preserves the liver and bodies of men from infectious diseases”.

Preventative: Garlic. (Old Chinese)

Milk Thistle: good responses observed.

General. Bedrest until motions are normal. Enema with any one of above herb teas.

Diet. Fat-free. Fasting period from 1-3 days on fruit juices and herb teas only. Artichokes. Dandelion coffee. Lecithin.

See: COCKROACH, The.

Treatment by or in liaison with a general medical practitioner. ... liver – acute infectious hepatitis

A set of symptoms, usually affecting women, that are very similar to cystitis but which occur in the absence of infection.... urethral syndrome, acute

the sudden uncontrolled development of severe abdominal symptoms secondary to disease or injury. Failure to establish a prompt diagnosis may lead to rapid clinical decline. Perforation of a peptic ulcer, an inflamed appendix or colonic diverticulum, or rupture of the liver or spleen following a crush injury all produce an acute abdomen requiring urgent treatment.... acute abdomen

a combination of angina (unstable or stable), non-S–T elevation *myocardial infarction (NSTEMI), and S–T elevation myocardial infarction (STEMI). It implies the presence of coronary artery disease.... acute coronary syndrome

a rare and life-threatening complication of pregnancy that usually presents in the third trimester with symptoms of nausea, vomiting, malaise, and abdominal pain. Liver function tests are abnormal and the features of *pre-eclampsia and often *HELLP syndrome are present. *Hepatic encephalopathy, *disseminated intravascular coagulation, and renal failure may develop, and the condition is associated with a high maternal and fetal mortality. Treatment involves a multidisciplinary approach, usually in an intensive care unit.... acute fatty liver of pregnancy

Painful infection and ulceration of the gums due to abnormal growth of bacteria that usually exist harmlessly in small numbers in gum crevices. Predisposing factors include poor oral hygiene, smoking, throat infections, and emotional stress. In many cases the disorder is preceded by gingivitis or periodontitis. The condition is uncommon, primarily affecting people aged 15–35.

The gums become sore and bleed at the slightest pressure. Crater-like ulcers develop on the gum tips between teeth, and there may be a foul taste in the mouth, bad breath, and swollen lymph nodes. Sometimes, the infection spreads to the lips and cheek lining (see noma).

A hydrogen peroxide mouthwash can relieve the inflammation.

Scaling is then performed to remove plaque.

In severe cases, the antibacterial drug metronidazole may be given to control infection.... gingivitis, acute ulcerative

Short-term inflammation of the liver, which usually recovers in 1–2 months. In some cases, acute hepatitis may progress to chronic hepatitis (see hepatitis, chronic), but it rarely leads to acute liver failure.

Acute hepatitis is fairly common.

The most frequent cause is infection with one of the hepatitis viruses (see hepatitis, viral), but it can arise as a result of other infections such as cytomegalovirus infection or Legionnaires’ disease.

It may also occur as a result of overdose of halothane or paracetamol or exposure to toxic chemicals including alcohol (see liver disease, alcoholic).

Symptoms range from few and mild to severe with pain, fever, and jaundice.

Blood tests, including liver function tests, may be used for diagnosis.

In most cases of acute viral hepatitis, natural recovery occurs within a few weeks.

If the disorder is caused by exposure to a chemical or drug, detoxification using an antidote may be possible.

Intensive care may be required if the liver is badly damaged.

Rarely, a liver transplant is the only way of saving life.

In all cases, alcohol should be avoided.... hepatitis, acute

A type of leukaemia in which excessive numbers of immature white blood cells called blasts are produced in the bone marrow. If untreated, acute leukaemia can be fatal within a few weeks or months. The abnormal cells may be of 2 types: lymphoblasts (immature lymphocytes) in acute lymphoblastic leukaemia, and myeloblasts (immature forms of other types of white cell) in acute myeloblastic leukaemia.

Exposure to certain chemicals (such as benzene and some anticancer drugs) or high levels of radiation may be a cause in some cases. Inherited factors may also play a part; there is increased incidence in people with certain genetic disorders (such as Fanconi’s anaemia) and chromosomal abnormalities (such as Down’s syndrome). People with blood disorders such as chronic myeloid leukaemia (see leukaemia, chronic myeloid) and primary polycythaemia are at increased risk, as their bone marrow is already abnormal.

The symptoms and signs of acute leukaemia include bleeding gums, easy bruising, headache, bone pain, enlarged lymph nodes, and symptoms of anaemia, such as tiredness, pallor, and breathlessness on exertion. There may also be repeated chest or throat infections. The diagnosis is based on a bone marrow biopsy. Treatment includes transfusions of blood and platelets, the use of anticancer drugs, and possibly radiotherapy. A bone marrow transplant may also be required. The outlook depends on the type of leukaemia and the age of the patient. Chemotherapy has increased success rates and 6 in 10 children with the disease can now be cured, although treatment is less likely to be completely successful in adults.... leukaemia, acute

(toxic pustuloderma) a reaction to a medication, resulting in the appearance of fine sterile *pustules on inflamed skin; the pustules may easily be overlooked. Common causes include penicillins, and pustular psoriasis must be excluded from the diagnosis.... acute generalized exanthematous pustulosis

see AKI.... acute kidney injury

acute kidney injury (see AKI).... acute renal failure

see adult respiratory distress syndrome.... acute respiratory distress syndrome

(ARF) a primary disorder of gaseous exchange (as distinct from failure of the mechanical process of breathing). The prototype of ARF is *adult respiratory distress syndrome, but the term sometimes also refers to disruption of any other part of the respiratory system, including the respiratory control centre in the brain with its *efferent and *afferent pathways.... acute respiratory failure

(ARN) severe inflammation and necrosis of the retina associated with inflammation and blockage of retinal blood vessels, haemorrhage and death of retinal tissue, and retinal detachment. It may affect both eyes (bilateral acute retinal necrosis, BARN), and visual prognosis is poor. ARN is thought to be due to viral infection.... acute retinal necrosis

see rheumatic fever.... acute rheumatism

(ATN) a condition caused by acute renal injury from either ischaemia or toxins and associated with tubular damage that is usually reversible. The earliest feature is *isosthenuria, which may occur while there is still a high urine flow rate. This is followed by a reduction in *glomerular filtration rate. *Oliguria is common and dialysis often needed for survival. If the cause of the initial damage can be removed, recovery of renal function within six weeks can be expected in most cases.... acute tubular necrosis

(abdominal dehiscence) spontaneous opening of a surgical wound after an abdominal operation.... burst abdomen

acute kidney injury caused by myoglobin that is released from damaged skeletal muscle (*rhabdomyolysis). This is usually the result of trauma and the condition was first recognized in victims trapped and crushed during the London Blitz. Muscle injury can also occur with pressure necrosis, particularly in the unconscious or immobile patient, or with a *compartment syndrome. Rarely it may complicate intensive muscular exercise or extensive viral myositis and it is a recognized complication of modest overexertion in some inherited disorders of muscle metabolism, such as *McArdle’s disease.... myoglobinuric acute renal failure