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Progressive bouts of acute abdomen: pet the peritoneum.

The recent discovery of the mutated gene responsible for Familial Mediterranean Fever (FMF) is supposed to facilitate its diagnosis which up till now is a clinical one because there are no specific laboratory tests. The sensitivity of genetic testing is limited because these tests search only for known mutations. In this case report we describe a patient with periodic abdominal pain in whom the diagnosis of FMF was wrongly discarded because of lack of a durable effect of colchicine and negative genetic testing. Diffuse peritoneal inflammation was nicely demonstrated by a FDG-PET (fluoro-deoxy-glucose positron-emission tomography) performed during a typical crisis. We discuss the possible diagnostic pitfalls and conclude that a crisis-PET might upgrade the level of diagnostic certainty in equivocal cases.

Abdomen, Acute↗
PubMed2006

The acute abdomen and HIV.

HIV-related disease continues to increase and presents the greatest single challenge to the medical practitioner seeking to alleviate suffering in the developing world. As a result, the practice of surgery cannot ignore the impact of HIV and must assess the implications of this new disease. Although much has been written of HIV-related surgical pathology, the preponderance of the literature reflects the experience of surgeons working in well-equipped hospitals in the First World where HIV prevalence is low and where there is ready access to a multiplicity of drug therapies and nursing backup.

AIDS-Related Opportunistic Infections↗