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

Poly arteritis nodosa (PAN) is a systemic vasculitis with a male: female ratio of 2:1 and a peak incidence in the fifth decade. Small to medium-sized arteries are involved by focal transmural inflammatory necrosis. Aneurysms with inflammatory destruction of the media also occur. The most frequently involved organs are the kidney, heart, lung, liver, and gastrointestinal tract. There are few reported cases of ischemic necrosis of the intestine and even fewer survivors. A 22-year-old woman was transferred to St. Thomas Hospital (Nashville, TN) after resection of 80 per cent of the small bowel for ischemic necrosis. She had a history of juvenile onset diabetes mellitus, recurrent abdominal pain, and splinter hemorrhages. Emergency aortogram and selective mesenteric arteriogram were performed. The celiac artery was not visualized and small aneurysms were present in the mesenteric and renal arteries. The patient was successfully resuscitated from a cardiac arrest in x ray from a cardiac tamponade. Laparotomy was performed to determine the viability of the bowel. The celiac, hepatic, and splenic arteries were found to be chronically occluded. Pathology of these arteries revealed a nonspecific arteritis. At a third operation, several more inches of small bowel were removed. Characteristic changes of PAN were present on all small bowel specimens. She was treated with high-dose cyclophosphamide and steroids for 6 months and has continued on low-dose cyclophosphamide. She is now 36 months from her original operation and is doing well on oral nutrition. Intestinal hemorrhage from aneurysm rupture or gangrene with perforation are gastrointestinal complications of PAN that the surgeon may be called upon to treat.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Surviving gastrointestinal infarction due to polyarteritis nodosa: a rare event. 134 8

A 56 year-old Japanese woman died suddenly after complaining of abdominal pain. Autopsy revealed typical aortic dissection with cardiac tamponade. Histologically, generalized granulomatosis with giant cells resembling sarcoidosis was found. The aorta was most strikingly affected so that granulomatous aortitis was regarded as the cause of the aortic dissection.
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PMID:Generalized granulomatous arteritis with aortic dissection. 378 10

The authors report on a 7-year-old boy who suffered an unintentional penetrating cardiac injury while misusing a lawn toy in a predictable way. The boy was hemodynamically stable, with abdominal pain and tenderness. The pericardial effusion was first noted on upper abdominal computerized tomographic images and was confirmed by echocardiography. A puncture wound of the anterior right ventricle was found. As in this case, children may not have the typical signs and symptoms of cardiac tamponade, making the diagnosis difficult and delaying appropriate care. This child's injury could have been prevented through increased parental supervision or a modified toy design that takes into account predictable patterns of misuse.
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PMID:An unusual cause of penetrating cardiac injury in a child. 886 87

The dissection is termed Type A according to the Stanford classification, if the ascending aorta is involved. It is termed type B, if the ascending aorta is not involved. Most patients with Type A aortic dissection die from intrapericardial rupture with cardiac tamponade, free pleural rupture, massive aortic regurgitation, or coronary or cerebral malperfusion (ischemic heart disease or stroke). Most patients with Type B dissection die from free pleural rupture or renal or visceral vascular complications. The resultant compromise of various aortic branches (inomunate, carotid, subclavian, spinal, renal, superior mesentric, or iliac arteries) results in a wide variety of symptoms and signs (shock, dyspnea, stroke, paraplegia, anuria, abdominal pain or extremity ischemia).
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PMID:[Pathophysiology and complications of aortic dissection]. 896 89

Among all the cases of hydatid disease seen in an 8-year period at Asir Central Hospital, Abha, Saudi Arabia, seven cases are reported here because of their unusual presentations. One patient had a brain hydatid cyst which presented as a space-occupying lesion. The second patient presented with symptoms and signs of cardiac tamponade due to pericardial hydatidosis. The third female had multiple abdominal and pelvic hydatid cysts causing vague abdominal pain, chronic ill-health and primary infertility. The fourth case was a huge single hydatid cyst filling the whole abdominal cavity and involving multiple organs. The fifth case presented with simultaneous involvement of the liver, right diaphragm and pleura with hydatidosis. The sixth case involved the left diaphragm and the patient presented with clinical picture simulating pleurisy. The last patient presented with a hydatid cyst of the right thigh. Even though there was no mortality in these patients, there was disabling morbidity. We conclude that Echinococcus granulosus can affect any organ in the body and a high suspicion of this disease is justified in endemic regions. Moreover, medical treatment should precede and follow the surgical intervention.
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PMID:Some rare presentations of hydatid cyst (Echinococcus granulosus). 980 11

The aim of the study was to determine the aetiology of large and symptomatic pericardial effusions and to review the management and subsequent outcome. A survey was done on a consecutive cases of patients who had undergone percutaneous pericardiocentesis over a 10 year period in a city centre general hospital serving a multiethnic catchment population. In all, 46 patients (24 male, 22 female; age range 16 to 90 years, mean 54 years) underwent a total of 51 pericardial drainage procedures (or attempted pericardiocentesis) between 1989 and 1998. Malignancy (44%), tuberculosis (26%), idiopathic (11%), and post-cardiac surgery (9%) were the most common causes of pericardial effusion. The most common presenting symptoms were breathlessness (90%), chest pain (74%), cough (70%), abdominal pain (61%) (presumed to be related to hepatic congestion), and unexplained fever (28%). In the 12 cases of tuberculous pericarditis, nine occurred in patients of Indo-Asian origin, and three in patients of Afro-Caribbean origin. Fever, night sweats, and weight loss were common among these patients, occurring in over 80% of cases of tuberculous pericarditis. Pulsus paradoxus was the most specific sign (100%) for the presence of echocardiographic features of tamponade, with strongest positive predictive value (100%). Although malignancy remains the most common cause in developed countries, tuberculous disease should be considered in patients from areas where tuberculosis is endemic. Percutaneous pericardiocentesis remains an effective measure for the immediate relief of symptoms in patients with cardiac tamponade, although its diagnostic yield in tuberculous pericarditis is relatively low.
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PMID:Management of pericardial effusion by drainage: a survey of 10 years' experience in a city centre general hospital serving a multiracial population. 1108 87

Traumatic haemopericardium is an uncommon but life threatening condition. It is usually caused by penetrating cardiac injuries or cardiac rupture from blunt chest trauma. We report haemopericardium and cardiac tamponade in a young girl after blunt abdominal trauma. She presented with mild upper abdominal pain, tachycardia and hypotension having been kicked in the abdomen by a horse. No damage was found at laparotomy and she remained haemodynamically unstable. Further investigation found cardiac tamponade and haemopericardium. This was managed by insertion of a pericardial drain using transthoracic echocardiogram guidance, with later drainage in the operating theatre using guidance with a transoesophageal echocardiogram.
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PMID:Delayed diagnosis of cardiac tamponade following isolated blunt abdominal trauma. 1206 51

We present the case of a 49 year old man who was admitted with odynophagia, fever and abdominal pain. Later he developed dyspnea and polymialgias. Pericardial effusion was detected on the echocardiogram. Renal failure and rhabdomyolysis developed worsening the clinical picture. A pericardial surgical drainage was decided due to cardiac tamponade. All samples were negative for bacteria and fungi. The presence of enterovirus in pericardial fluid was confirmed.
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PMID:[Myopericarditis due to enterovirus in association with rhabdomyolysis and renal failure]. 1180 26

A 39-year-old man was admitted for upper abdominal pain and shortness of breath. The chest roentgenogram demonstrated cardiomegaly and left lower lobe atelectasis. Echocardiography showed circumferential pericardial effusion with signs of cardiac tamponade. Pericardial biopsy and fluid analysis were consistent with fibrino-purulent pericarditis. Despite broad-spectrum antibiotics, percutaneous and subsequently surgical drainage, pericardial effusion and tamponade recurred. We report successful treatment of a non-resolving fibrino-purulent pericardial effusion by combined intrapericardial irrigation of fibrinolytics and systemic corticosteroids administration as an alternative to pericardectomy.
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PMID:Intrapericardial urokinase irrigation and systemic corticosteroids: an alternative to pericardectomy for persistent fibrino-purulent pericarditis. 1237 12

Cardiac tamponade is an infrequent but potentially lethal complication related to use of central venous catheters (CVC). We present the case of a 16-year-old female with Diamond-Blackfan anemia (DBA) who developed pericardial tamponade secondary to superior venous caval obstruction caused by CVC thrombosis. The patient presented 3 months after line placement with vomiting, abdominal pain, and cardiomegaly on chest X-ray (CXR). Her condition quickly decompensated with cardiac arrest and subsequent death despite immediate pericardiocentesis. As a result of this case, our center has developed a protocol for the management of CVC problems as a means of facilitating rapid recognition of central line clots.
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PMID:Central venous catheter thrombosis as a cause of SVC obstruction and cardiac tamponade in a patient with Diamond-Blackfan anemia and iron overload. 1576 84


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