Author/Editor		Kupnik, Dejan; Vadnjal, Sabina; Brvar, Mirjana
Title		Pacient z netipično klinično sliko akutnega abdomna in akutnega miokardnega infarkta v ambulanti SNMP
Translated title		A patient with an atypical clinical picture of acute abdomen and acute myocardial infarction
Type		članek
Source		In: Bručan A, Gričar M, Vajd R, editors. Urgentna medicina: izbrana poglavja. Zbornik 10. mednarodni simpozij o urgentni medicini; 2003 jun 11-14; Portorož. Ljubljana: Slovensko združenje za urgentno medicino,
Publication year		2003
Volume		str. 175-80
Language		slo
Abstract		Patients with an atypical clinical picture of acute abdomen and acute myocardial infarction are not so rare. The purpose of this paper is to present two patients who could be easily mistreated regarding to their clinical picture. It is therefore worthwhile to stress that an atypical clinical picture doesn't exclude illnesses known from the books. The main problem of the patient with the pyloric perforation was the pain in the right renal region which propagated to the front and down to the scrotum. The right renal succusion was very painful and the teststicks for urine showed increased number of erythrocites. Plain radiography of the abdomen showed no significant sign but ultrasonic examination of the abdomen revealed a thin layer of free fluid over the left liver lobe. The patient with an acute myocardial infarction presented with nausea and vomiting. She said that early that morning she had bad diarrhea, cramps in the stomach and slightly elevated body temperature. The plain radiography of the abdomen is still the first diagnostical choice when the pneumoperitonem is suspected. Ultrasound has its place in selected cases. The paper stresses the importance of considering a possibility of a so called sealed and radiologicaly invisible perforation of the stomach in the patients surgicaly treated for the same condition in the past.
Descriptors		STOMACH RUPTURE MYOCARDIAL INFARCTION ELECTROCARDIOGRAPHY ADULT