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[Laparotomy for acute abdomen in larvate depression]
Helvetica Chirurgica Acta
|February 1, 1980
Summary
Larvate depression, often presenting as abdominal pain, can mimic acute surgical conditions. This case highlights the importance of psychiatric evaluation before surgery in such complex presentations.
Area of Science:
- Psychiatry
- Gastroenterology
- Surgical Pathology
Background:
- Psychosomatic disturbances, particularly abdominal issues, are common in depressive patients.
- Larvate depression, characterized by somatic symptoms, is increasingly recognized and can be challenging to diagnose.
- Inadequate diagnosis of larvate depression may lead to unnecessary surgeries.
Observation:
- A 37-year-old female presented with acute abdomen symptoms, initially suspected to be mechanical or reflectory ileus.
- Despite extensive investigations ruling out mechanical causes, her condition rapidly deteriorated, suggesting a perforated ulcer.
- An exploratory laparotomy revealed no abnormal findings, prompting a psychiatric consultation.
Findings:
- The patient was ultimately diagnosed with depression by a consultant psychiatrist.
- This case represents a rare presentation of severe somatic symptoms mimicking an acute surgical abdomen due to depression.
- No similar cases with such an acute presentation were found in specialized psychiatric literature.
Implications:
- The case questions the standard diagnostic pathway for acute abdomen, suggesting psychiatric referral before surgical intervention in select cases.
- Early psychiatric assessment may prevent misdiagnosis and unnecessary surgical procedures in patients with somatic symptoms of depression.
- This underscores the need for interdisciplinary collaboration between surgical and psychiatric teams to manage complex psychosomatic presentations.