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

Fifty-six patients with symptomatic metastatic melanoma of the gastrointestinal tract (GIT) treated surgically at the Sydney Melanoma Unit between 1974 and 1989 were reviewed. The majority of these patients presented with abdominal pain or symptoms of anemia. The small intestine was the site of metastasis in more than 80 per cent. The mean over-all survival time was 11.7 months (range of one to 60 months) after surgical treatment of a first metastasis to the GIT and 3.6 months (range of zero to 12 months) postoperatively for a second GIT metastasis. Forty-four of the patients reported complete relief of their symptoms postoperatively. The results suggest that an aggressive approach to symptomatic GIT metastases from malignant melanoma is justified both to relieve distressing symptoms and to prolong life.
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PMID:The justification for surgical treatment of metastatic melanoma of the gastrointestinal tract. 223 26

The authors describe the course of Crohn's disease in two boys and six girls aged 11.1-15.6 years. In three patients with terminal ileitis and affection of the ascendent colon the disease is characterized by prolonged growth retardation, subfebrile temperatures, abdominal pain. For patients with granulomatous colitis, blood-stained diarrhoea is typical abdominal pain and loss of body weight. Three patients were treated first for idiopathic proctocolitis and only in the course of the disease the diagnosis of Crohn's disease was established. In 87.5% of the patients on admission anaemia was found and all patients had a varying elevated red cell sedimentation rate and CRP. The author draws attention to extraintestinal symptoms (dermal, ophthalmological, articular, somatic retardation) which precede in particular somatic retardation) which precede in particular in affections of the small intestine intestinal manifestations. Their erroneous interpretation may delay the establishment of the diagnosis of Crohn's disease. The author emphasizes the importance of basic laboratory examinations and examination by ultrasound for early detection of patients.
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PMID:[Clinical picture of Crohn's disease in children and adolescents]. 224 75

Wilson disease presenting as fulminant hepatic failure, severe hemolysis and renal failure is rare in the literature. A ten-year-old boy--complaining of abdominal pain, jaundice, tea-colored urine, and anemia was admitted to this hospital; examination showed Kayser-Fleischer rings, anemia associated with hemolysis, mildly elevated serum transaminases, extremely elevated bilirubin levels, low serum ceruloplasmin level, slightly elevated serum copper, excessive 24-hour urine copper excretion, and severe renal function insufficiencies. Under the impression of Wilson disease with fulminant hepatic failure, the patient was treated by oral D-penicillamine 1 gm per day, intravenous zinc sulphate (about 8 mg per day elemental zinc), and given other supportive treatment. Unfortunately, the patient died of hepatic failure complicated with septic shock 21 days after the onset of symptoms. Autopsy found liver copper content was 586.92 ug/gm dry weight and kidney copper content: 300.19 ug/gm dry weight, abnormally high as compared with normal tissue. A review of the literature led to conclusion that the best treatment for Wilson fulminant hepatic failure is liver transplantation.
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PMID:[Wilson disease presenting as fulminant hepatic failure, acute hemolytic anemia and renal failure: report of one case]. 226 86

A patient with multiple, pyogenic hepatic abscesses is described, and the pathophysiology, etiologies, clinical and laboratory manifestations, and management of the disease are reviewed. A 55-year-old man with a history of ethanol abuse and pancreatitis developed fever, chills, general malaise, and right upper quadrant abdominal pain two weeks before hospitalization. Baseline laboratory and hematology results included serum albumin concentration, 3.2 g/dL; serum alkaline phosphatase concentration, 239 mIU/mL; total serum bilirubin concentration, 1.3 mg/dL; white blood cell count, 18,400/cu mm; red blood cell count, 4.7 million/cu mm; hemoglobin, 12.5 g/dL; and hematocrit, 38.8%. Abdominal ultrasound showed echo-free cavities throughout the hepatic parenchyma; abdominal computed-tomography (CT) scan showed hepatomegaly and multiple radiolucent spaces. CT-guided needle aspiration of a hepatic mass yielded purulent material that grew Fusobacterium necrophorum under anaerobic conditions. On day 7, the patient was started on i.v. ampicillin sodium-sulbactam sodium. A CT scan two weeks later showed a reduction in the number and sizes of abscesses. The patient continued i.v. therapy for one month, then was discharged on a regimen of p.o. amoxicillin trihydrate-clavulanate potassium. Hepatic abscesses are either amebic or pyogenic; the latter usually has a higher mortality. The etiologies of pyogenic hepatic abscesses include ascending cholangitis, portal vein bacteremia, systemic bacteremia, extension from a contiguous focus of infection, and trauma. Diagnosis is difficult and relies highly on clinical suspicion. Clinical symptoms include hepatomegaly, fever, chills, and malaise. Abnormal laboratory values include leukocytosis, anemia, and hypoalbuminemia. The abscesses are frequently polymicrobial; Escherichia coli is the most commonly isolated species. CT is the best radiological technique for diagnosis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Ampicillin-sulbactam therapy for multiple pyogenic hepatic abscesses. 229 77

The case records of 19 mares undergoing caudal ventral midline celiotomy for cesarean section were reviewed. Surgical exposure to the uterus was good, and the incisions healed by first intention in surviving mares. Seventeen mares (89%) survived to time of hospital discharge. Six foals (32%) were delivered alive, of which three were euthanatized because of severe deformity (1 died on day 6 and 2 survived to time of discharge). The most frequent postoperative complications were abdominal pain (13 mares), anemia (10 mares), and retained placenta (6 mares). Sixteen mares were bred during at least one season after the cesarean section and eight (50%) produced at least one foal. The collective foaling rate for these mares, bred a total of 25 seasons, was 36%. Only one mare bred during the same year as the surgery produced a live foal. The collective foaling rate for mares bred after the year of the surgery was 50%.
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PMID:Cesarean section in 19 mares. Results and postoperative fertility. 230 Nov 60

To assess the contribution of fecal blood testing to cancer detection in a clinical practice setting, we studied records from 160 patients with both a new tissue diagnosis of colorectal adenocarcinoma and a preceding stool blood test (HemoQuant, Mayo Medical Laboratories, Rochester, Minn) determination. In this group, 71% had suggestive colorectal symptoms (particularly stool changes, overt bleeding, and abdominal pain) or anemia at presentation, and 29% were asymptomatic. Fecal blood levels remained normal in more than 40% of both symptomatic and asymptomatic patients. In only 26 patients (16% overall) was an abnormal fecal blood level the sole heralding feature, but this subset of patients had a more favorable stage. Fecal blood levels were higher with advanced, larger, and more proximal tumors and with stools collected before purgation. We conclude that, in the practice setting, fecal blood level elevation alone is an uncommon but important manner of colorectal cancer presentation, most cancers present with symptoms, and fecal blood levels are often normal in both symptomatic and asymptomatic patients.
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PMID:Colorectal cancer detection in the practice setting. Impact of fecal blood testing. 233 Nov 99

The paper reports a case of a 45-year-old female with long-standing anemia, recurrent abdominal pain and subocclusive crises. Following a negative endoscopy of the upper tract of the large intestine, barium enema and angiography, the patient underwent total colonoscopy. Massive bleeding from the ileal valve suggested an ileal pathology: a small intestine enema confirmed a polypoid proliferation 60 cm above the Bahuino valve with related ileal invagination 25 cm long. The patient underwent surgery and pathological findings revealed a 7 cm-wide ileal lipoma near a small angiodysplasia. The latter seemed to be the cause of bleeding. The diagnosis of small intestine tumours is made difficult by the fact that the only important signs are abdominal pain, intestinal bleeding and subocclusive crises, which are common symptoms in many pathologies. The authors stress the importance of a thorough endoscopic examination and selective angiography.
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PMID:[Lipoma of the small intestine. A clinical case]. 233 68

A 60-year-old man with primary splenic hemangiosarcoma (PSH) presented with weakness, weight loss, abdominal pain, and anemia. Physical examination revealed hepatomegaly, ascites, and firm, huge splenomegaly. Ultrasonography showed many nodular structures characterized by hypoechogenic and hyperechogenic areas. The patient also had portal hypertension, which was confirmed by physical findings and by measurement of portal vein pressure during operation. A liver-spleen scan using Tc-99m sulfur colloid and Tc-99m labeled heat denatured erythrocytes failed to demonstrate any splenic uptake, a reliable feature of functional asplenia. Although on a total body scan with Ga-67 citrate there was no splenic uptake, there was gallium uptake in the liver, where the presence of the metastatic lesion was histopathologically verified and confirmed by operation. There was also uptake in the middle zones of the lungs. Ga-67 citrate imaging appears to be helpful in the diagnosis of metastasis of PSH, and PSH can rarely cause portal hypertension.
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PMID:Functional asplenia and portal hypertension in a patient with primary splenic hemangiosarcoma. 234 Jun 75

The purpose of this study was to investigate the prevalence and type of lesions in the upper gastrointestinal tract and to identify characteristics associated with ulcer disease among geriatric inpatients with positive faecal occult blood test and/or iron deficiency anaemia. Two thousand five hundred and four patients aged 60-98 (mean, 82) years admitted to a geriatric clinic for rehabilitation were screened by faecal occult blood test, for B-haemoglobin, and, in a case of anaemia, analyses of serum levels of mean corpuscular volume, mean corpuscular haemoglobin concentration, iron, and total iron-binding capacity. One hundred and seventy patients were included in the study. A high prevalence of ulcer disease (22%) was found. Significantly higher proportions of non-steroidal anti-inflammatory drugs and steroid users and of patients with rheumatoid arthritis and osteoarthrosis were found among ulcer patients than among patients without ulcerative upper gastrointestinal lesions. The clinical picture of ulcer disease differed from the classic presentation: abdominal pain occurred in only 7 of 38 patients (18%), whereas appetite and weight loss and nausea/vomiting were common. It is important to be aware of the high prevalence and the clinical picture of ulcer disease among geriatric inpatients with iron deficiency anaemia and/or occult gastrointestinal bleeding.
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PMID:Ulcer disease among geriatric inpatients with positive faecal occult blood test and/or iron deficiency anaemia. A prospective study. 235 77

In a retrospective survey, the clinical details of all children with primary peptic ulcer seen at Red Cross War Memorial Children's Hospital over a 12-year period were analysed. The diagnosis was confirmed in 31 cases, 22 of whom had a duodenal ulcer. Gastro-intestinal bleeding was the presenting symptom in 19 patients. In 7 of these there were no preceding symptoms, rendering earlier diagnosis impossible. Those presenting with abdominal pain had a mean interval of 2.8 years between onset of symptoms and diagnosis. Useful clinical clues in these children were epigastric tenderness and anaemia. To avoid diagnostic delays, peptic ulcer disease should be considered more often in children with abdominal pain. When available, gastro-intestinal tract endoscopy should be the diagnostic investigation of choice.
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PMID:Primary peptic ulcer disease in childhood. 240 5


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