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

Anemia is common in cancer patients and is associated with reduced survival. Recent studies document that treatment of anemia with blood transfusion in cancer patients is associated with increased infection risk, tumor recurrence, and mortality. We therefore investigated the incidence of preoperative anemia in colorectal cancer and assessed risk factors for anemia. Prospective data were collected on 311 patients diagnosed with colorectal cancer over a 6-year period from 1994 through 1999. Patients were stratified by age, gender, presenting complaint, preoperative hematocrit, American Joint Committee on Cancer (AJCC) stage, and TNM classification. Discrete variables were compared using Pearson's Chi-square analysis. Continuous variables were compared using Student's t test. Differences were considered significant when P < 0.05. The mean age of the study cohort was 67 +/- 9.2 with 98 per cent of the study population being male. The mean AJCC stage was 2.2 +/- 1.2 and the mean preoperative hematocrit was 35 +/- 7.9 with an incidence of 46.1 per cent. The most common presenting complaints were hematochezia (n = 59), anemia (n = 51), heme-occult-positive stool (n = 33), bowel obstruction (n = 26), abdominal pain (n = 21), and palpable mass (n = 13). Preoperative anemia was most common in patients with right colon cancer with an incidence of 57.6 per cent followed by left colon cancer (42.2%) and rectal cancer (29.8%). Patients with right colon cancer had significantly lower preoperative hematocrits compared with left colon cancer (33 +/- 8.5 vs 36 +/- 7.4; P < 0.01) and rectal cancer (33 +/- 8.5 vs 38 +/- 6.0; P < 0.0001). Patients with right colon cancer also had significantly increased stage at presentation compared with left colon cancer (2.3 +/- 1.3 vs 2.1 +/- 1.2; P < 0.02). Age was not a significant risk factor for preoperative anemia in colorectal cancer. We conclude that there is a high incidence of anemia in patients with colon cancer. Patients with right colon cancer had significantly lower preoperative hematocrits and higher stage of cancer at diagnosis. Complete colon evaluation with colonoscopy is warranted in patients with anemia to improve earlier diagnosis of right colon cancer. A clinical trial of preoperative treatment of anemic colorectal cancer patients with recombinant human erythropoietin is warranted.
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PMID:Preoperative anemia in colon cancer: assessment of risk factors. 1207 43

The stage of a colorectal carcinoma represents the most important prognostic factor regarding the probability of survival. The primary objective of this study was to document the management of patients with colorectal carcinoma after onset of symptoms. Factors influencing the delay in definitive therapy should thus be determined. Anthropometric, social, and operative data were obtained by standardized questionnaires from 40 patients with colonic cancer and 30 patients with rectal cancer. The influence of delayed treatment on outcome was analyzed. A significant correlation was found for the time between onset of first symptoms and definitive surgical therapy with tumor stage (colon cancer: r = 0.52, p < 0.05; colorectal cancer: r = 0.62, p < 0.05). The time delay in rectal carcinoma patients averaged 224 days and in patients with colonic carcinoma 149 days. Social influences such as profession, type of education, marital status, and quality of health insurance had a significant influence on treatment delay, as did the clinical experience of the physician first contacted. The leading symptom in patients with rectal cancer was peranal hemorrhage, and in patients with colonic cancer it was abdominal pain. The main causes of iatrogenic delay were insufficient clinical investigation and a lack of awareness when typical first symptoms were present. Delayed treatment of colorectal cancer seems to be a multifactorial problem. Causes for such delay are found not only in the patients and their social environments but also in the type and quality of their medical care systems. Intensified education and earlier prevention are the major aims for patients and their physicians.
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PMID:Delay in treatment of colorectal cancer: multifactorial problem. 1260 56

This study reports for the first time the detection of Brachyspira aalborgi in faeces and rectal biopsies of a female suffering for 3-4 months of abdominal pain with long-standing mucosal diarrhoea, rectal bleeding and suspected carcinoma of the rectum. After pre-treatment of samples (faeces and biopsies) with a liquid medium (trypticase soy broth-TSB) containing foetal calf serum (FCS, 10%) and spectinomycin and rifampicin (TSB-SR) the first detection of B. aalborgi isolate HBS1 was observed after 48 h in the primary plates of selective blood agar modified medium (BAM) containing spectinomycin and rifampicin (BAM-SR), where growth zones were signalled by a small weakly beta-haemolytic halo. Attempts to subculture spirochaetes in agar media failed. The new HBS1 isolate was only propagated in TSB broth and at electron microscopy it showed 4 endoflagella inserted at each tapered end. The phenotypic characterization of HBS1 demonstrated absence of hippurate hydrolysis, indole production, alpha-galactosidase, alpha- and beta-glucosidase activities in accordance with the B. aalborgi type strain. Rapid identification of B. aalborgi isolate HBS1 was performed directly from faeces and rectal biopsies and subsequently from pure cultures by a genetic method based on 16S DNA restriction fragment length polymorphism (RFLP)-polymerase chain reaction (PCR). The sequence of 16S DNA amplicon of the isolate HBS1 was found 99.2% corresponding to that of the B. aalborgi type strain. Our results encourage further investigations for the development of a suitable selective agar medium for the isolating and cultivating B. aalborgi from human specimens.
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PMID:Rapid detection and identification of Brachyspira aalborgi from rectal biopsies and faeces of a patient. 1264 29

This is the case of a 67-year-old woman with a sudden on-set of lower abdominal pain and pre-shock. A physical examination showed signs of pan-peritonitis. Emergency was operation performed 5 hours after the onset. She had undergone Hartmann's operation for rectal cancer. Six month after the operation, abdominal CT scan revealed the mass of puriform acites, about 20 mm in diameter, in the right suprarenal region. Right adrenalectomy was performed with a diagnosis of solitary adrenal metastasis from rectal cancer. Histologically, the metastatic adenocarcinoma was moderately differentiated to the adrenal medulla. The capsule was kept intact, and no swelled lymph nodes were found around the adrenal gland. There have been no signs of recurrence for 4 years after the operation.
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PMID:[A case of rectal cancer with solitary adrenal metastasis]. 1555 87

Emphysematous cystitis is a rare form of acute cystitis presenting with gas collection in the bladder wall and lumen. We report three cases of emphysematous cystitis. The first patient was a 71-year-old woman with gross hematuria. Intravenous pyelography and cystoscopy revealed a characteristic gas collection in the bladder. The second patient was a 59-year-old man with abdominal fullness who was hospitalized for treatment of a cerebral infarction. Abdominal radiography and computed tomographic (CT) scan demonstrated emphysematous cystitis. The third patient was a 67-year-old man with diarrhea and abdominal pain after operation for rectal cancer. CT scan accidentally showed gas bubbles in the bladder wall and lumen. All of the cases, the symptoms were improved after treatment with antibiotics.
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PMID:[Three cases of emphysematous cystitis]. 1675 28

A 49-year-old male was admitted to Sendai Saiseikai Hospital with a complaint of upper abdominal pain. Perforative rectal cancer was diagnosed, and an emergency laparotomy was done. Transient colostomy and drainage for peritonitis were performed. Preoperatively rectal cancer was assessed to invade the sacral bone and prostate. A total of 50 Gy radiation therapy with low dose CDDP+5-FU chemotherapy was conducted for five weeks. Remarkable shrinkage of the tumor was found, and elective surgery for curative intent was done on April 2000. The tumor seemed to invade the adjacent tissues such as prostate and urine bladder, so extensive resection of the urine bladder and sacral bone was done in addition to abdominal perineal resection. Pathological exploration showed complete regression of the tumor and no tumor invasion to the prostate and sacral bone. He is well without tumor relapse. Once complete regression of the rectal cancer by chemo-radiation therapy has been achieved, relapse of the tumor was reported to be rare. Preoperative chemo-radiation therapy is an effective tool to control the advanced rectal cancer.
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PMID:[A case of advanced rectal carcinoma, preoperative chemo-radiation therapy leading to histological complete response]. 1696 39

A 56-year-old-man complained of abdominal pain, and was diagnosed as having advanced rectal cancer with synchronous multiple metastatic liver cancer (H 3) in July 1999. He underwent low anterior resection and hepatic partial resection (S 1, S 2+S 3, S 5, S 6, S 8) in August 1999. In addition, he underwent hepatic arterial infusion chemotherapy (HAI) 6 times at ADM 30 mg+5-FU 1,000 mg+MMC 16 mg between October 1999 and July 2000 for recurrent metastatic liver cancer. He has survived more than 6 years after the initial surgery. Multidisciplinary treatment with hepatic resection may well be a strategy for patients with multiple colorectal liver cancer, even though H 3 type of metastasis.
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PMID:[A case of effective multidisciplinary treatment with hepatic resection for synchronous multiple liver metastases from rectal cancer]. 1703 41

This case report series describes eight patients (four patients with pancreatic carcinoma, one patient with hepatocellular carcinoma, one patient with gastric and rectal carcinoma, one with sigmoid colon cancer, and one with rectal cancer), whose abdominal cancer pain was treated with intravenous phentolamine infusion at 80 mg x day(-1) for 2 days. All but one of the patients had already been treated with opioids. All eight patients complained of severe abdominal pain; in five patients the pain radiated to the back, and there was associated anal pain in two patients. Analgesia was achieved in three patients; pain alleviation was obtained in four patients, but was not sustained in two of these four patients; and the treatment in one patient could not be judged for efficacy because epidural morphine was used together with the phentolamine. Adverse effects of phentolamine were tachycardia and/or hypotension.
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PMID:Intravenous phentolamine infusion alleviates the pain of abdominal visceral cancer, including pancreatic carcinoma. 1768 Jan 99

Carcinoma rectum is a very uncommon malignancy in childhood. The incidence of colon cancer is found to be 1.3 cases per million children. An eleven years old boy with carcinoma rectum was admitted in the Department of Paediatric Gastroenterology, Bangabandhu Sheikh Mujib Medical University (BSMMU). The boy presented with irregular fever, altered bowel habit, poor appetite, gradual weight loss and abdominal pain. His abdomen was tender with no organomegaly. The rectal wall was tender and hard mass could be felt in the surrounding area on direct rectal examination. Diagnosis was confirmed by biopsy of the tissue from the growth. Surgical resection and anastomosis was done. After one month of surgery chemotherapy was started. Since carcinoma rectum in children has not been reported in Bangladesh we share the information with professionals.
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PMID:Carcinoma-rectum in an 11 years old boy. 1791 38

A 55-year-old woman underwent a low anterior resection for rectal cancer 7 years earlier at a different hospital. Thereafter, she often had such symptoms as abdominal pain, frequent bowel movements, and constipation. We considered postoperative bowel adhesion to be the cause of these symptoms, and a laparoscopic adhesiotomy was therefore performed twice. However, the symptoms did not substantially improve thereafter. A colonoscope of conventional diameter could barely pass through the anastomotic site of the operation, but we initially judged the anastomotic stricture to not be severe. However, we finally determined the anastomotic stricture to be the cause of these symptoms; X-ray examinations frequently showed the blockage of feces or the collection of gas images in the colon when the symptoms occurred. We therefore performed endoscopic balloon dilation (EBD) after performing electroincision of the scar tissue of the anastomotic ring. We dilated the area of the lesion to a diameter of 20 mm using the EBD technique, and thereafter the patient finally showed an improvement in quality of life. There have been some reports describing the usefulness of EBD for the treatment of colorectal anastomotic stricture. Past studies have reported the indications of EBD to include stricture, which is defined as a narrowed anastomosis through which a 12-mm-diameter colonoscope cannot be passed. Nevertheless, it seemed that when the clinical manifestations of anastomotic stricture are clear, such as those observed in our case, we should not too strictly adhere to this definition.
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PMID:An improvement in the quality of life after performing endoscopic balloon dilation for postoperative anastomotic stricture of the rectum. 1808 36


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