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

This paper presents in detail the symptomatology and findings on examination of 642 patients suffering from a variety of lower gastrointestinal disorders, such as colonic and rectal cancer, diverticular disease, Crohn's disease, and ulcerative colitis. Location of precise sites of abdominal pain and tenderness was shown to carry a high level of diagnostic discrimination between the various disorders. Some surprising features emerged: almost half of patients with lower gastrointestinal tract disease complained of symptoms referable to the upper gastrointestinal tract, such as nausea/vomiting or anorexia. It is suggested that the provision on demand of such data to junior staff may benefit both diagnostic ability and decision making. As an incidental finding, just under 40% of patients with large bowel cancer had undergone previous (unrelated) abdominal surgery. The significance of this is unclear.
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PMID:Clinical presentation of diseases of the large bowel. A detailed study of 642 patients. 124 82

Two rare cases of a primary, diffusely infiltrating carcinoma (linitis plastica) of the colon are reported. Case 1: In a 54-year-old male complaining of constipation and bloody stool, stenosis in the lower rectum was detected. He was diagnosed as having rectal cancer and rectal amputation with R3 lymphadenectomy was performed. The histological diagnosis was a signet ring cell carcinoma (a2, n2(+), Ho, Po stage IV). The patient died of multiple metastasis on the 318th postoperative day. Case 2: In a 29-year-old male complaining of a lower left abdominal pain, a circular stenosis of 7.5 cm in length in the descending colon, with Schnitzler's metastasis, was found. In spite of the advanced stage, a palliative colectomy was performed. A circular thickness of the wall was noted macroscopically, and the histological diagnosis was signet ring cell carcinoma, (s, n4(+), Ho, Po, stage V). The patient died of multiple metastasis on the 25th postoperative day.
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PMID:[Two cases of primary, diffusely infiltrating carcinoma (linitis plastica) of the colon]. 215 8

A 63-year-old Hispanic man from Peru who recently had immigrated to the United States presented with progressive weakness, weight loss, recurrent abdominal pain and passing bright red blood per rectum. Rectal carcinoma was suspected. Biopsies of two lesions in the sigmoid colon showed granuloma inguinale (donovanosis). A computed tomographic scan of the abdomen revealed a large presacral mass. A radiographically guided fine needle aspiration (FNA) of the presacral mass showed findings characteristic of granuloma inguinale. FNA thus proved to be a useful adjuvant in the diagnosis of an unusual case of granuloma inguinale (donovanosis) presenting with a presacral mass that had the radiologic characteristics of a malignant tumor.
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PMID:Diagnosis of an unusual abdominal presentation of granuloma inguinale by fine needle aspiration cytology. 237 27

We have studied the epidemiology of colorectal cancer in Asturias. We have collected 850 cases of colonic and rectal cancer, diagnosed from 1977 to 1981 (470 males and 380 females). The incidence was 17.13 per 100,000 for males and 13.08 per 100,000 for females. The incidence adjusted for the age was 12.32 (males) and 7.95 (females). The average age was 63.68 and 64.06, for females and males, respectively. The more frequent localization were rectum, sigmoid colon and cecum. Two hundred and sixty two patients lived in rural areas and 588 in urban areas. In 57.9% of the cases of blood group was A. The most common presenting symptoms were abdominal pain and blood in the feces. 69.9% of the tumors were Dukes' type C. The treatment was elective surgery in 693 cases. Five years after surgery the survival rates were 44.1% for tumors type C, and 68.5% for tumors type B. During the period of present study underlines the importance of the programs directed to the early diagnosis of high risk groups, as an efficient secondary prevention of the colorectal carcinoma.
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PMID:[Epidemiology of cancer of the colon and the rectum in Asturias (1977-1981)]. 263 40

Continuous arterial infusion chemotherapy is associated with a significantly greater tumor response rate, though patients must be hospitalized for a long time. This paper describes techniques and our experience with arterial continuous infusion chemotherapy for outpatients using implantable port and ambulatory pump. Eleven patients (liver metastasis of colorectal cancer, hepatocellular carcinoma and local recurrence of rectal cancer) were treated with continuous arterial infusion chemotherapy at our outpatient clinic. The chemotherapy infusions were carried out repeatedly for 5.7 months on average (10-2 months) with 5-FU or CDDP. Total periods of infusions were 64.8 days on the average (136-24 days). The infusion dose and frequency of drug refilling were limited by pump quality. A major complication occurred only in one patient who developed arterial thrombosis. Minor complications were mainly gastrointestinal symptoms (nausea, vomiting) and abdominal pain, which were easily corrected with drugs. The tumor responses were as follows: PR 1 case, MR 1 case, NC 7 cases and PD 2 cases. Home arterial continuous infusion chemotherapy reduced the hospitalized period and helped patients return to work. Therefore it may well contribute to improve the quality of life of cancer patients.
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PMID:[Continuous arterial infusion chemotherapy in cancer cases followed as outpatients]. 278 3

Colorectal adenocarcinoma are rare in Madagascar. Over a period of 8 years, such tumors were treated in the cancerology and surgery departments of Antananarivo. The low incidence and the relative young age at the time of diagnosis are comparable to observations made in other developing countries. Men represent 47 of the cases and women 34. On the average, patients were 52.3 years old (range: 23-78 years). The most frequent early symptoms are rectorrhagia (26 cases) for rectal cancer, abdominal pain (9 cases) and transit bowel disorders (9 cases) for colon cancer. Between the first symptom and diagnosis, the average delay is 8.5 months (range: 2 days-37 months). No risk factor was found. Thirteen patients did not receive any treatment, 8 were only submitted to radiotherapy and 60 were surgically treated with a curative intent in 26 cases, a palliative one in 32 cases and for diagnosis in 2 cases. Among the 63 tumors available for modified Dukes' classification of Astler-Coller, 9.5% are stage B1, 23.8% are stage B2, 11% are stage C1, 15.9% are stage C2 and 39.7% are stage D; there are no stage A. There is no epidemiological particularity for these cancers in Madagascar. The poor prognosis is probably mainly related to a lack of appropriate medical and surgical facilities.
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PMID:[Colorectal cancer in Madagascar. A study of 81 cases diagnosed and treated at the Antananarivo General Hospital]. 321 23

The authors report on the case of a 12-year-old girl on whom surgery was performed for primary carcinoma of the rectum with a case history of one year. The tumour had already infiltrated the vagina. Abdominoperineal amputation of the rectum was performed. An extended tumour relapse and metastases in the liver were found on relaparotomy which had to be performed three years later The prognosis was, therefore, unfavourable indeed. Numerous publications prove that carcinoma of the rectum must be given differential diagnostic consideration even in childhood, especially if there are unclear deposits of blood in the faeces in conjunction with abdominal pain and loss of weight. Usually, the "fatal pause" between the first symptoms and the correct diagnosis is too long. Once the disease has progressed to an advanced stage, carcinoma of the rectum has a very unfavourable prognosis even in children. Simple digito-rectal examination can decisively improve the survival rate.
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PMID:[Rectal carcinoma in childhood]. 664 10

From 1979 to 1995, 27 patients who had familial adenomatous polyposis (FAP) were treated at the authors' institution. Most patients (n = 23) presented as a result of a previous family history of FAP. Eighteen patients presented with symptomatic colonic disease that included bloody stools (n = 14), diarrhea (n = 10), and abdominal pain (n = 6). Treatment consisted of a total colectomy, rectal mucosectomy, and straight endorectal pull-through (ERPT) in 26 of 27 patients. One patient preferred to undergo an ileoanal J pouch reconstruction. A temporary diverting loop ileostomy was performed in 25 patients and closed at an average of 100 days after the ERPT. Follow-up has been achieved in 100% of the patients and ranges from 6 to 182 months with an average of 48 months. Postoperative complications included partial bowel obstruction (two patients, one requiring enterolysis); and mild pouchitis (one patient). Two of the 27 patients required proctectomy and permanent ileostomy procedures, one for rectal cancer that was present microscopically in the initial rectal specimen from the ERPT and the other because of recurrent anastomotic complications. No patient required revision of the straight pull-through to a pouch or takedown of the pull-through as a result of persistent diarrhea or dissatisfaction. All of the patients are continent, and 80% deny any soiling during bouts of gastroenteritis. The mean number of bowel movements reported was 10 per day at the first postoperative clinic visit with a gradual decreased to six per day after 2 years. Initial use of bulking (62%) and antimotility agents (88%) decreased significantly over the course of follow-up to 29% and 67%, respectively at the most recent follow-up (average, 48 months) of each patient. Pelvic sepsis, which occurs in 8% of most series of patients who have pouches, did not occur in any of our patients. Pouchitis, a common complication with pouches (23%), occurred in only one of the patients and was mild and easily treated medically. This series demonstrates that total colectomy with rectal mucosectomy and straight ERPT eliminates the risk of colorectal cancer and achieves continence with a low complication rate and excellent functional results and patient satisfaction.
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PMID:Efficacy of the straight endorectal pull-through in the management of familial adenomatous polyposis--a 16-year experience. 926 57

We report a patient with rectal ulcer with severe stenosis, who underwent urgent surgical treatment for perforated peritonitis. The 54-year-old man suddenly developed cramping abdominal pain and fever while hospitalized, with signs of peritoneal irritation. An emergency laparotomy was performed, and severe stenosis of the rectum and a perforated lesion on the oral side approximately 10 cm distant from the stenosis were found, with massive abdominal purulent fluid. He was treated by rectosigmoid colon resection with transverse colon loop colostomy. Histopathologically, the stenosis was caused by ulceration extending to all muscular layers of the rectum, with inflammatory changes. Benign rectal stenosis is so rare that differential diagnosis from malignancy may be difficult when there are inflammatory changes in the surrounding tissues. However, it is necessary to keep in mind the likelihood of this disease in differentiation from rectal cancer.
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PMID:A patient with rectal ulcer with severe stenosis presenting with perforated peritonitis. 1063 43

Tegafur is a prodrug of the antineoplastic agent fluorouracil, and is administered in a 1:4 molar ratio with the fluorouracil modulator uracil. Oral tegafur/uracil 300 mg/m(2)/day plus calcium folinate 75 or 90 mg/day for 28 days every 35 days was as effective as intravenous (IV) fluorouracil 425 mg/m(2)/day plus folinic acid 20 mg/m(2)/day for 5 days every 28 or 35 days in the treatment of patients with metastatic colorectal cancer in two large, randomised, nonblind, multicentre trials (n = 816 and 380). Median survival time among patients treated with tegafur/ uracil or fluorouracil was approximately 12 months in both trials. Results from both trials also demonstrated no significant between-group differences in overall response rates among patients treated with oral tegafur/uracil (12 and 11%) or IV fluorouracil (15 and 9%). In elderly patients (aged > or = 70 years) with metastatic colorectal cancer, results from small noncomparative studies showed that treatment with oral tegafur/uracil afforded overall response rates of 12.5 to 29% and was well tolerated. During preoperative treatment with oral tegafur/uracil plus calcium folinate as an adjunct to radiotherapy in patients with stage II or III rectal cancer, the maximum tolerated dosage of tegafur/uracil was 350 mg/m(2)/day (administered 5 days per week for 5 weeks). Among the 15 patients who were followed for 5 to 8 months, three had a complete response to treatment. Treatment with tegafur/uracil was also given postoperatively. The most common adverse events associated with oral tegafur/uracil were anaemia, nausea/vomiting, diarrhoea, thrombocytopenia, mucositis, neutropenia, asthenia, anorexia and abdominal pain. Oral tegafur/uracil was associated with a significantly more favourable tolerability profile than IV fluorouracil in the two large randomised trials. In particular, stomatitis and most adverse haematological events were less frequent.
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PMID:Oral tegafur/uracil. 1188 48


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