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

Eleven cases of diverticular disease of the colon were seen in a review of 603 adult barium enema examinations carried out over a 2-year period (January 1984-December 1985) at the University College Hospital, Ibadan, Nigeria--a prevalence of 1.85%. All the cases were clinically unsuspected and the diagnosis was established only at barium examination. Five of the 11 patients presented with rectal bleeding, six with alteration in bowel habit, six with abdominal pain and associated fever and one with right iliac fossa pain and tenderness mimicking appendicitis. Although an uncommon disease in Nigerians, clinicians are urged to suspect diverticular disease in their differential diagnoses of disorder of the colon in Africans in order not to miss a potentially lethal but treatable condition.
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PMID:Diverticular disease of the colon in Ibadan, Nigeria. 255 53

In a survey of emergency admissions to hospital in rural Thailand, acute appendicitis was the commonest cause of acute abdominal pain. Estimates of the incidence of appendicitis, in two series comprising a total of 356 patients, at 3.2 and 3.7 per 10,000 population per year, were relatively high compared with reports from other warm climate countries. In comparison with 1825 cases in studies sponsored by the Organisation Mondiale de Gastroenterologie (OMGE), Thai patients with acute appendicitis were older, presented late and experienced more complications than those in 14 other countries. In Khon Kaen only 2-3% of the cases were children aged 0-9 years, compared with 9-26% in the OMGE series. In patients admitted to hospital with acute abdominal pain in Thailand, acute appendicitis was diagnosed more often than non-specific abdominal pain. The converse was true in the OMGE series. This may reflect the longer distances travelled to hospital by many patients and delays between onset of symptoms and admission to hospital. Acute appendicitis was the commonest definitive diagnosis in both series. This survey indicates that relatively high rates of acute appendicitis may occur in populations eating traditional diets. The results are consistent with the recently described hypothesis of an infective aetiology and increases in appendicitis rates may be expected in people born since the introduction of improvements in environmental sanitation. Further studies are needed to examine trends in the incidence of appendicitis in populations eating traditional diets with both high and low fibre content and to investigate the significance of changing social and environmental factors.
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PMID:Acute abdominal pain and appendicitis in north east Thailand. 258 11

In an audit of 1190 emergency admissions with abdominal pain (1166 patients) in a general surgical unit, the diagnosis was non-specific abdominal pain (NSAP) in 415 (35 per cent), acute appendicitis in 200 (17 per cent) and intestinal obstruction in 176 (15 per cent). The largest number of admissions occurred in the age groups 10-29 years (31 per cent) and 60-79 years (29 per cent). Surgical operations were performed in 551 patients (47 per cent) and there was a 16 per cent incidence of unnecessary appendicectomy (22 per cent in the age group 20-29 years). Fifty-one deaths resulted in a 30-day hospital mortality rate of 4.4 per cent and a perioperative mortality rate of 8 per cent. The mortality rate increased significantly in patients aged greater than or equal to 60 years, and patients aged 80-89 years had a perioperative mortality rate of 20 per cent. The causes of perioperative death included laparotomy for inoperable disease (28 per cent), ruptured abdominal aortic aneurysm (23 per cent), perforated peptic ulcer (16 per cent) and colonic resections (14 per cent). The perioperative mortality rates for ruptured aneurysm and perforated ulcer were 71 and 23 per cent respectively. The duration of inpatient stay increased significantly with the age of the patients, including those with NSAP. The results of the study indicate a need to review the methods of management of ruptured aortic aneurysm and perforated peptic ulcer, the methods of diagnosis of appendicitis, particularly in young females, and the factors that determine the duration of stay of patients suffering from NSAP.
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PMID:Abdominal pain: a surgical audit of 1190 emergency admissions. 259 64

Twenty-four pregnant women with acute appendicitis received exploratory laparotomy during an 8-year period. Abdominal pain accompanied with nausea and vomiting were the most common symptoms. Abdominal tenderness and rebounding pain were the most reliable physical signs. Leukocytosis with WBC count greater than 15,000/cu mm and granulocytes greater than 87% and prolonged symptomatic duration were indications that appendiceal perforation might have occurred. A McBurney's incision and spinal anesthesia were preferred for appendectomy during pregnancy. In cases of uncomplicated appendicitis, tocolytic agents and antibiotics were not routinely used. Premature labor occurred in 21% of patients during postoperative period.
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PMID:Appendicitis during pregnancy. 263 59

In conclusion, the most important task in evaluating an immigrant or traveler with abdominal pain is to consider the myriad tropical diseases that mimic common western conditions. A careful history may point to antecedent symptoms and a time course that are incompatible with typical appendicitis, biliary colic, or bowel obstruction, but physical examination is generally not specific enough to differentiate between tropical and ordinary abdominal crises. Blood work for eosinophilia and a rapid examination of the stools by an experienced technician may indicate a need for judicious delay in exploratory laparotomy. In this interval, imaging studies, serologic tests, and therapeutic drug trials may clarify the diagnosis.
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PMID:Tropical medicine and the acute abdomen. 266 58

Anisakiasis is a zoonotic disease caused by the ingestion of larval nematodes in raw seafood dishes such as sushi, sashimi, ceviche, and pickled herring. Symptoms of anisakiasis include abdominal pain, nausea, vomiting, and diarrhea. Because symptoms are vague, this disease is often misdiagnosed as appendicitis, acute abdomen, stomach ulcers, or ileitis. Endoscopic examination with biopsy forceps has facilitated the diagnosis of gastric anisakiasis. Worms can be removed and identified, and a definitive diagnosis can be made. Patients generally recover with no further evidence of disease. Worms can become invasive, however, and migrate beyond the stomach, penetrating the intestine, omentum, liver, pancreas, and probably the lungs. Surgery is often necessary for treatment of invasive anisakiasis. With the increase in popularity of eating lightly cooked or raw fish dishes, the number of cases of anisakiasis may be expected to increase.
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PMID:Anisakiasis. 267 Jan 91

Conventional diagnostic tools have hitherto demonstrated low levels of specificity in establishing the diagnosis of appendicitis. We conducted a retrospective study of all patients who underwent abdominal or pelvic compression ultrasonography during a 15 month period based on variable clinical suspicion of appendicitis. Ultrasonographic interpretations were correlated with surgical and pathologic findings and clinical follow-up study. The initial 76 prospective ultrasonographic readings, interpreted by multiple examiners, were labeled group 1. The criterion used to diagnose appendicitis in this group was visualization of a noncompressible target-like structure with a hypoechoic wall greater than 2 millimeters in diameter. Ultrasonography was found to be 66.7 per cent sensitive, 90.6 per cent specific and 86.8 per cent accurate in the diagnosis of appendicitis, with a positive predictive value of 57.1 per cent and a negative predictive value of 93.5 per cent. We reassembled 70 of the original ultrasonographic examinations and retrospectively reanalyzed these studies (group 2), using the most recently published criterion, which requires a maximal appendiceal diameter of greater than 6 millimeters. Ultrasonography was shown to be 80.0 per cent sensitive, 95.0 per cent specific and 92.9 per cent accurate in diagnosing appendicitis, with a positive predictive value of 72.7 per cent and a negative predictive value of 96.6 per cent. Ultrasonographic examination provided additional findings, predominantly gynecologic or obstetric, in 52 per cent of the women, leading to an alternative diagnosis in one-third of these patients with complaints of abdominal pain. Ultrasonographic study provided additional findings in 12 per cent of the men, leading to alternative diagnoses in 12 per cent. Ultrasonographic results directly influenced clinical management in 18 per cent of the patients. As suggested in the most recent literature, appendiceal ultrasonographic examination is a reliable ancillary technique in diagnosing or excluding appendicitis. It is indicated only in patients with an atypical or equivocal presentation; those with clinical grounds do not require ancillary diagnostic aids and should proceed immediately to surgical intervention. The predominant role of ultrasonography in evaluating appendicitis is not as an independent diagnostic determinant. Instead, it is most useful as a means of improving decision making when considered in combination with a thorough history and physical examination in those patients who represent diagnostic dilemmas.
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PMID:Compression ultrasonography as an aid in the differential diagnosis of appendicitis. 267 57

Endometriosis affects 8%-15% of all women, and of these 3%-37% have intestinal involvement. Affected women are typically of childbearing age and of low parity, with a history of cyclic abdominal pain and progressive dysmenorrhea. Endometriosis may involve the rectum and sigmoid, ileum, cecum, and appendix, generating symptoms suggestive of acute obstruction, appendicitis, ileitis, diverticulitis, or colonic carcinoma. Thus, this entity should be included in the differential diagnosis of recurrent abdominal pain and other episodic bowel symptoms in women of childbearing age.
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PMID:Intestinal endometriosis and its complications: case report and review. 267 1

Numerous abdominal manifestations were noted among 600 patients undergoing treatment at Hospital Laennec for various stages of infection by the acquired immunodeficiency virus. These included violent abdominal pain in 30% of cases, the development of abdominal lymphoma, and occasionally alarming pseudo-surgical syndromes. Diagnosis is difficult, all the more so since authentic emergencies may be aggravated by the immunodeficiency state. 18 cases were collected in 3 years and included 6 cases of acute cholecystitis and 2 of appendicitis. The gangrenous and extensive nature of infection was generally noted and required appropriate antibiotic therapy.
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PMID:[Surgical emergencies and pseudo-surgical syndromes in the course of acquired immunodeficiency syndromes in adults]. 269 92

In order to establish a guide for the diagnosis of acute appendicitis, we reviewed the charts of patients with appendectomy. In a 7-year period, 385 patients were studied. The age range was 3 to 15 years. In 53% there was an administration of medications prior to surgery. Perforated appendicitis was found in the majority (53%) of the cases. We could not find any association between age and perforation. Only localized, persistent abdominal pain, peritoneal irritation, anorexia, and vomiting were useful for differential diagnosis. In patients with acute appendicitis (p greater than 0.05), leukocytosis (greater than 10,000/mm3), neutrophilia (greater than 70%) and bands (greater than 3%) were observed in 80% of the cases. The frequency of complications was elevated (39.5%), and the mortality was five times higher than referred in other studies. We propose an algorithm for both opportune diagnosis and treatment of the disease.
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PMID:[Acute appendicitis in children. Experience at a general hospital]. 271 47


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