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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report 2 homosexual patients with the acquired immune deficiency syndrome and histopathologic evidence for cytomegalovirus colitis. In each case, the initial endoscopic impression was Kaposi's sarcoma but the appropriate diagnosis was made by histologic demonstration of a cytomegalovirus vasculitis. Clinical manifestations may include diarrhea, abdominal pain, and hematochezia. Fulminant progression to gangrenous bowel was documented in 1 patient and was associated with histologic evidence of severe cytomegalovirus vasculitis. The pertinent clinical, endoscopic, and pathologic findings are reviewed.
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PMID:Cytomegalovirus colitis. Report of the clinical, endoscopic, and pathologic findings in two patients with the acquired immune deficiency syndrome. 298 Oct 79

Barium radiography of the gastrointestinal tract in patients with AIDS can assist in the evaluation of numerous problems including dysphagia, odynophagia, diarrhea, abdominal pain, symptoms of intermittent obstruction, and/or gastrointestinal bleeding. It can localize disease, evaluate complications, guide endoscopic biopsy, and monitor the progress of therapy.
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PMID:Gastrointestinal imaging in AIDS--luminal gastrointestinal tract. 304 60

The diagnosis and treatment of abdominal pain and anorectal disease in AIDS patients are discussed. Emphasis is placed on the practical aspects of patient care.
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PMID:Abdominal pain and anorectal disease in AIDS. 304 67

Four patients with acquired immunodeficiency syndrome (AIDS) (CDC group IV) were investigated for biliary disease because of the presence of both severe upper abdominal pain and raised levels of serum alkaline phosphatase. None was clinically jaundiced. Upper abdominal ultrasound was abnormal in three. All had endoscopic retrograde cholangiographic evidence of both an intrahepatic sclerosing cholangitis suggestive of primary sclerosing cholangitis and an irregular suprapapillary common bile duct dilation suggestive of papillary stenosis. Three had evidence of gastrointestinal cryptosporidiosis and two of disseminated cytomegalovirus infection. Endoscopic sphincterotomy, performed in two patients, gave good pain relief. We propose the name 'AIDS sclerosing cholangitis' for this form of secondary cholangitis. The cause of this disorder remains unclear. Recent evidence is discussed which suggests that it is not due to HIV itself but to an opportunistic infection. Cryptosporidium appears to be the most likely candidate.
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PMID:Sclerosing cholangitis in acquired immunodeficiency syndrome. Case reports and review of the literature. 307 60

Strongyloides stercoralis, the only helminthic parasite that can complete its life cycle in the human host, is also the only helminthic parasite that has been reported with any frequency in AIDS patients. Symptoms include hives, skin eruptions, abdominal pain, perianal pruitis, diarrhea, and pneumonitis. Diagnosis is made by demonstrating rhabditiform larvae in the stool or female parasitic worms and eggs in the small intestinal mucosa; in disseminated cases, rhabditiform or filariform larvae can be found in liver, heart, lungs, thyroid, kidneys, adrenals, pancreas, lymph nodes, and central nervous system. Successful treatment has been achieved with thiabendazol. Strongyloidiasis is uncommon, but since cell-mediated immunity is important in combatting this organism, and since T-lymphocyte function is impaired in AIDS patients, strongyloidiasis should not be overlooked in the diagnosis of opportunistic illnesses in these individuals.
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PMID:Helminthic infections in the acquired immunodeficiency syndrome. 324 5

The first case of AIDS positively identified in a non-foreigner in Taiwan was a 25-year-old unmarried male who had practiced homosexuality for ten years. The patient began to have abdominal pain accompanied with loose stools and weight loss in June 1985, followed by fever, cough, headache, dizziness, and loss of memory. Facial hyperpigmentation and extensive oroesophageal candidiasis were noted. Laboratory studies showed severe lymphopenia with a reversed T-helper to T-suppressor ratio, cutaneous anergy and polyclonal gammopathy. Human immunodeficiency virus (HIV) antibodies were positive by ELISA and Western blot, and the virus was isolated from the blood. At autopsy, disseminated cytomegalovirus infection, extensive CNS toxoplasmosis and early lesions of Kaposi's sarcoma were demonstrated. The detection of HIV in the adrenal medulla supports the consensus that the virus is neurotropic.
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PMID:An autopsy-proved case of AIDS in Taiwan. 330 20

Despite the recognition of Mycobacterium avium complex (MAC) infection as a common complication of AIDS, the specific clinical features, significance, and need for treatment have been difficult to assess. We reviewed the clinical records and autopsy material of 68 patients dying with AIDS, 32 (47 percent) of whom had MAC isolated from autopsy tissue. All had postmortem evidence of systemic infection. Eleven (34 percent) had MAC isolated from lung tissue. Little, if any, local tissue inflammation and destruction were associated with MAC infection. Patients with autopsy evidence of MAC infection had a longer time interval from diagnosis of AIDS to death. The infection was detected antemortem in 14 (44 percent), blood culture being the most sensitive means (86 percent yield). Although recurrent fever was noted among both MAC infected and uninfected patients, weight loss greater than 20 lb, weakness, anorexia, abdominal pain, and diarrhea were more frequent among infected patients. Severe anemia, thrombocytopenia, lymphopenia, and reduced mean CD-4 percentages and CD-4/CD-8 ratios were associated with MAC infection. Of eight patients who had MAC cultured antemortem and received multidrug antituberculosis therapy, none responded clinically, and all but one had MAC isolated at autopsy. Because MAC is associated with significant discomfort and disability, development of more effective treatment regimens could be beneficial for some affected AIDS patients.
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PMID:Mycobacterium avium complex infection in patients with the acquired immunodeficiency syndrome. A clinicopathologic study. 335 47

Lead poisoning is uncommon in the adult population, but must be considered in the differential diagnosis of patients with abdominal pain of obscure etiology. In this paper we present a 38-yr-old male with abdominal pain, a history of alcohol abuse, and exposure to the virus responsible for acquired immunodeficiency syndrome. The cause of pain was elusive until his occupation as a housepainter was appreciated. The diagnosis of lead poisoning then was considered and confirmed by an elevated blood lead level and symptomatic response to therapy. With the increase in renovation of old buildings, it is likely that the incidence of lead poisoning will become more common.
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PMID:Inorganic lead poisoning in an adult. 336 17

Five children with the acquired immunodeficiency syndrome (AIDS) and unusual gastrointestinal disease are described. Two children presented with malnutrition, abdominal distention, and diarrhea. One was found to have moderately severe villus atrophy on jejunal biopsy and was initially thought to have celiac disease. Jejunal biopsy from the second child revealed infiltration of the mucosa with acid-fast bacilli-laden macrophages. A third child suffered recurrent abdominal pain, progressive weight loss, diarrhea, and severe gastrointestinal hemorrhage secondary to infection with cytomegalovirus. Pseudomembranous necrotizing jejunitis associated with overgrowth of Klebsiella pneumoniae in the duodenal fluid occurred in one patient. The fifth child presented in the newborn period with Serratia marcescens cholecystitis. Gastrointestinal disease in children with AIDS may be due to idiopathic villus atrophy and bacterial or opportunistic infection.
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PMID:Severe gastrointestinal involvement in children with the acquired immunodeficiency syndrome. 343 Feb 58

Eight homosexual men with the acquired immunodeficiency syndrome (AIDS) presented with clinical, biochemical, and radiologic features of stenosis of the papilla of Vater and sclerosing cholangitis. This newly recognized complication of AIDS produces abdominal pain, nausea, and vomiting and may predispose patients to superimposed bacterial cholangitis. Marked elevation of serum alkaline phosphatase levels and lesser changes in hepatic aminotransferase levels are common. Although abdominal ultrasonography and computed tomography detect ductal abnormalities, endoscopic retrograde cholangiography best shows precise ductal irregularities and provides therapeutic intervention. Prompt relief of symptoms follows endoscopic sphincterotomy, often with resolution of biochemical evidence of cholestasis. Biliary tract infection with cytomegalovirus or cryptosporidia and resultant viral or coccidial cholangitis are the proposed pathophysiologic mechanisms.
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PMID:Papillary stenosis and sclerosing cholangitis in the acquired immunodeficiency syndrome. 354 23


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