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

Tuberculosis (TB) in human immunodeficiency virus (HIV) immunosuppressed patients is characterized by extra-pulmonary disease in as many of 70% of them. If intestinal or lymph node involvement occurs, the differential diagnosis between an acute abdomen and other non surgical conditions may be a challenging problem. The authors analyzed eight double infected patients (TB and acquired immunodeficiency syndrome AIDS), who were admitted to the University Hospital (HUCFF) of the Federal University of Rio de Janeiro. This association should be considered when abdominal pain, anemia, fever, weight loss and abdominal lymph node enlargement are present. Bacteriology of body fluids, abdominal ultrasound (US) and computed tomography scans (CT) combined with guided needle aspiration biopsies, barium examination, colonoscopy and laparoscopy, can not only elucidate the diagnosis but also be helpful in assessing an appropriate management. Thus a systematic evaluation often yields an etiology and a correct therapeutic indication reducing the high mortality rate.
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PMID:Intra-abdominal tuberculosis in acquired immunodeficiency syndrome. Diagnosis and management. 853 Feb 32

Acute pancreatitis in HIV-infected patients with or without AIDS has been reported with increasing frequency over the past several years. Drugs used to treat HIV-infected patients are often the cause. We report a case of a 46-year-old HIV-infected man who presented to the emergency department with abdominal pain and was diagnosed with acute pancreatitis. The patient had recently begun taking 2',3'-dideoxyinosine (ddI). He died shortly after admission to the hospital; CT scan and autopsy confirmed the cause of death as hemorrhagic pancreatitis. We briefly review the literature on the incidence and severity of pancreatitis in association with ddI and pentamidine therapy.
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PMID:Fatal pancreatitis as a complication of therapy for HIV infection. 853 Jul 81

Gastrointestinal symptoms attributable to Toxoplasma gondii infection are distinctly unusual, and antemortem diagnosis of gastrointestinal involvement is rarely documented, particularly in the absence of cerebral manifestations or disseminated disease. This case report describes a rare example of T. gondii infection of the stomach diagnosed antemortem in a 22-year-old Haitian woman with acquired immunodeficiency syndrome (AIDS) who presented with fever and abdominal pain. An abdominal computerized tomographic scan showed thickened gastric walls. Endoscopy showed diffusely thickened gastric folds and a fundic ulcer along the greater curvature. Light and electron-microscopic examination of gastric mucosal biopsy specimens showed active Toxoplasma infection with necrosis and intracellular trophozoites within the gastric epithelium, smooth muscle cells, macrophages, and endothelial cells. Both true cysts and pseudocysts were seen. Disseminated disease was documented by the growth of T. gondii in a tissue culture from a venous blood sample. It is concluded that some patients with AIDS, particularly those from areas endemic for Toxoplasma infection, can manifest disseminated disease in unusual locations such as the gastrointestinal tract. Documentation of active T. gondii infection based on tissue cultures of venous blood or on biopsy specimens of symptomatic extracerebral sites can lead to a rapid diagnosis of toxoplasmosis, a treatable disease.
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PMID:Gastric toxoplasmosis in acquired immunodeficiency syndrome: antemortem diagnosis with histopathologic characterization. 853 65

We have examined the changing demographics of adult intussusception and implicate human immunodeficiency virus (HIV)- and acquired immune deficiency syndrome (AIDS)-associated gastrointestinal pathology as risk factors for intussusception in young adults. The clinical index of suspicion for intussusception should be raised for an HIV-positive young adult with intermittent crampy abdominal pain. Over a 10-year period, eight cases of adult intussusception were diagnosed at our institution, and we reviewed the diagnostic computed tomography (CT) scans and records of these patients to correlate them with radiological studies, clinical history, surgical findings, laboratory studies, pathologic analysis, and outcome. Three of the eight patients with adult intussusception had AIDS, all diagnosed by CT scans. Their average age was 41 years, whereas average age of the non-HIV-associated patients was 63. These findings suggest that HIV- and AIDS-associated gastrointestinal pathology provide lead points for intussusception and are significant risk factors for intussusception in young adults. We reviewed the five previously reported cases of AIDS and intussusception and conclude that intussusception should be a diagnostic consideration in an HIV-positive young adult with abdominal complaints. It is clear that AIDS-associated intussusception is a real clinical problem and that CT is an effective method of diagnosing it.
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PMID:AIDS-associated intussusception in young adults. 858 84

We report three cases of colonic histoplasmosis observed in a non-endemic area in patients with AIDS. The patients presented with fever, abdominal pain and an abdominal mass in the right lower quadrant. Diagnosis was obtained using Gomori-Crocott staining of endoscopic or surgical biopsies. One patient died without specific treatment and two patients had a complete remission when treated with intravenous amphotericin B but suffered a relapse when given oral itraconazole. Thus, physicians in areas where intestinal histoplasmosis is not endemic should be aware of the condition. Diagnosis can easily be obtained using Gomori-Crocott staining of colonoscopic biopsies; this should avoid unnecessary laparotomies and allow specific treatment to be instituted rapidly.
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PMID:Intestinal histoplasmosis in AIDS patients: report of three cases observed in France and review of the literature. 859 Jan 65

Massive steatosis has recently been described among a few human immunodeficiency virus-seropositive patients who were receiving antiretroviral therapy. Although clinical and light-microscopic pathological findings were carefully described, no ultrastructural studies of the liver were performed in these cases. We report the light-microscopic and ultrastructural findings at autopsy of a 35-year-old woman with AIDS who developed severe lactic acidosis and hepatic failure. The patient had been receiving standard doses of zidovudine for 5 months when she was hospitalized because of the rapid onset of abdominal pain, nausea, and vomiting. The most significant findings at autopsy were massive hepatomegaly and steatosis. Ultrastructural examination of the liver and skeletal muscle showed slightly enlarged mitochondria in the liver but no mitochondrial changes in the skeletal muscle. The pathogenesis of mitochondrial toxicity associated with antiviral therapies is briefly discussed.
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PMID:Massive hepatic steatosis and lactic acidosis in a patient with AIDS who was receiving zidovudine. 864 49

Viral acute pancreatitis in Human Immunodeficiency Virus (HIV) infected patients has been occasionally described. We studied nine patients with HIV antibodies and acute pancreatitis attributed to Cytomegalovirus and/or Cryptosporidium infection. In four patients the clinical picture was consistent with acute pancreatitis while in five clinical manifestations were unspecific, and diagnosis was based on ultrasonography and/or computed tomography findings. In the HIV infected patient pancreatic evaluation by imaging techniques may disclose acute pancreatitis even in the absence of abdominal pain.
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PMID:[Acute pancreatitis and acquired immunodeficiency syndrome]. 866 74

We report a patient with AIDS and intestinal microsporidiosis. While undergoing treatment with albendazole, he developed worsening diarrhea with abdominal pain and fever. The diagnosis of pseudomembranous colitis was made by flexible sigmoidoscopy and a positive stool specimen for Clostridium difficile toxin. The patient's symptoms resolved with oral vancomycin and his stool C. difficile toxin became negative. Albendazole is an antibiotic that is chemically related to metronidazole. Although a few case reports link metronidazole with the development of pseudomembranous colitis, albendazole has not been associated with the development of this condition. The spectrum of antimicrobial activity of albendazole and its efficacy in the treatment of intestinal microsporidiosis are reviewed. Pathogenic mechanisms for the development of pseudomembranous colitis and the epidemiology of this condition in patients with AIDS are discussed.
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PMID:Albendazole-induced pseudomembranous colitis. 867 15

When a 40-year-old patient with end-stage acquired immunodeficiency syndrome (AIDS) had bloating and abdominal pain, a large epidemic Kaposi's sarcoma (EKS) lesion was found obstructing the pylorus. Treatment consisted of single-agent chemotherapy for the disseminated lesions and external beam irradiation to the obstructing lesion. Within days of radiation therapy, symptoms began to resolve, and by completion of therapy, the patient was virtually asymptomatic. Although EKS is common in homosexual men infected with the AIDS virus, these patients usually succumb to overwhelming opportunistic infections. Nevertheless, palliative courses of radiation, which can produce a complete response in 50% to 100% of treated KS lesions, can substantially improve the quality of life in these patients.
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PMID:Disseminated epidemic Kaposi's sarcoma treated with radiation and chemotherapy. 868 61

Between October 1991 and October 1993, 17 AIDS patients (14 intravenous drug users, 3 sexually acquired) were commenced on percutaneous endoscopic gastrostomy (PEG) feeding in St James's Hospital. Indications were progressive weight loss related to severe anorexia, persistent oesophageal candidiasis (5) and absence of gag reflex (1). Two patients requested PEG tube removal after one week because of crampy abdominal pain without peritonitis. Five patients died from AIDS related infections within 6 weeks of PEG insertion. Ten patients were followed up for > 2 months (mean 5.2 months, range 2.5-15.5 months). In these 10 patients, 1 patient developed a PEG site infection which responded to topical antibiotics. There were no other complications. There was a significant (P < 0.001) increase in energy and protein intake at 2 months. Variant degrees of weight gain occurred in all patients (mean 2.6 kg) (P < 0.01). Small but significant increases in other anthropometric variables occurred. Patients who died within 6 weeks of PEG insertion were older, and had a lower serum albumin than the group who survived > 2 months (P < 0.01). A self-administered questionnaire demonstrated that the majority of patients found PEG feeding acceptable and preferable to nasogastric (NG) feeding.
Int J STD AIDS
PMID:An evaluation of percutaneous endoscopic gastrostomy feeding in AIDS. 873 34


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