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

Over a 5 year period 268 abdominal aortic aneurysms were operated on, 15 of these (5.6%) showed the characteristic features of inflammatory aneurysms. Rupture of the aneurysm was an unusual method for presentation (one patient), and back and abdominal pain were present in 13 patients. The ESR may be of value in the pre-operative diagnosis. Ultrasound and CT scanning can, by the detection of a peri-aortic mass lead to confusion in the diagnosis. Two patients were initially diagnosed as having lymphoma. Strict adherence to the surgical principles outlined resulted in no mortality or significant morbidity in these 15 patients.
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PMID:Inflammatory aneurysms of the abdominal aorta. 386 92

Theca lutein cysts are benign neoplasms known to be associated with twins, molar pregnancy and erythroblastosis fetalis, but they are only rarely associated with a normal singleton pregnancy. Their natural course is postpartum spontaneous regression. Documented cases were noted because of abdominal pain or dystocia. This paper reports theca lutein cysts which were asymptomatic and were first noted ultrasonographically in a singleton gestation at term. In a few published cases and in a larger number of unpublished cases, apparent confusion as to the benign nature of these cysts has led to unwarranted bilateral oophorectomy. Asymptomatic theca lutein cysts undoubtably occur more commonly than they are reported. With the increasing use of ultrasonography and cesarean section, this condition probably will be observed more frequently in the future. At the time of laparotomy in late pregnancy with ovaries which appear pathological, tissue biopsy and evaluation is of critical importance in order to avoid unnecessary castration in this group of young women.
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PMID:Diagnosis and management of bilateral theca lutein cysts in a normal term pregnancy. 626 Apr 42

In a review of 22 years of clinical experience, we found seven previously healthy children with primary peritonitis. The diagnosis was made at laparotomy in all patients. Their symptoms included diffuse abdominal pain, fever, vomiting, and diarrhea. Abdominal tenderness was maximal in the right lower quadrant in five children, which led to confusion with the diagnosis of acute appendicitis. Streptococcus pneumoniae was identified as the etiologic agent in three patients and group A beta-hemolytic Streptococcus in one patient. The remaining three patients all had prior antibiotic therapy, and peritoneal fluid cultures were sterile. All children had a prompt response to treatment with antibiotics and recovered without complications. Long-term follow-up (4 1/2 to 15 years) was available for three patients; all three remained healthy.
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PMID:Primary peritonitis in previously healthy children. 638 16

The case of a 24-year-old man who accidentally ingested liquid zinc chloride is presented. Local caustic effects included erosive pharyngitis and esophagitis. Nausea, vomiting and abdominal pain, as well as hypocalcemia and hyperamylasemia, suggested acute pancreatitis. Microhematuria occurred, but renal function did not deteriorate. Lethargy and confusion, noted previously in another case of hyperzincemia, were present. Chelation therapy was instituted, with reversal of the clinical and biochemical effects of zinc poisoning.
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PMID:Accidental ingestion of liquid zinc chloride: local and systemic effects. 678 11

Forty cases of cerebral Plasmodium falciparum malaria seen at San Lazaro Hospital, Manila, Philippines from 1979-1981 were reviewed. These cases represented 7% of all Plasmodium falciparum cases seen during this period. All of the patients had fever and headache, 73% confusion, 70% chills, 68% jaundice or abdominal pain, 60% sweats. Findings more frequent in the fatal compared to the non-fatal cases were: the presence of schizonts in the peripheral smear, oliguria, coma, convulsions, urinary incontinence, jaundice, pulmonary symptoms and vomiting. Fatal cases were less likely to be clinically diagnosed as malaria and more likely to be diagnosed as hepatitis than malaria. The treatment and management of these cases is discussed.
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PMID:Cerebral malaria at San Lazaro Hospital, Manila, Philippines. 717 Jun 37

Nine cases of pseudomembranous colitis (PMC) were observed during a 20-month period. All patients had received, or were taking, antibiotics, in five cases lincomycin. The clinical syndrome of PMC occurred in two patients after a major gastrointestinal operation, in two after fracture of the neck of the femur, and in the remaining five, after administration of antibiotics for inflammatory diseases. The clinical syndrome was characterized by an acute onset of profuse diarrhea, pyrexia, abdominal pain, dehydration, and in four patients confusion or hypotension. The diagnosis was made on the basis of rectosigmoidoscopy and histology. No attempt was made to isolate Cl. difficile or to identify neutralizable fecal toxin. All patients received metronidazole at a dose of 1.5 gr. daily with a good response. Eight patients recovered fully. Only one died.
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PMID:Pseudomembranous colitis. Treatment by metronidazole. 721 47

Hyperparathyroid crisis is a rare disease but should be suspected in acutely ill patients complaining of weakness, lethargy, nausea, vomiting, confusion and abdominal pain. Despite the variety of clinical manifestations, the syndrome forms a distinctive pattern which, in the presence of a serum calcium level greater than 16 mg/100 ml, should be recognized. The most difficult problem in diagnosis is the differentiation of hyperparathyroid crisis from ectopic parathyroid hormone-producing tumors. The disease is an endocrine emergency which requires prompt surgery after rapid correction of dehydration and hypercalcemia. The best results are achieved by removing offending parathyroid tissue within 72 hours after the onset of symptoms.
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PMID:Primary hyperparathyroidism: hyperparathyroid crisis. 730 6

A 24-year-old man presented to the emergency department with nausea, vomiting, abdominal pain, and an acute confusional state of 6 hours' duration. Ten hours before admission, he had ingested a mixture of orange juice and six ground leaves, later identified as Nerium oleander (common pink oleander) leaves. His blood pressure was 100/80 mm Hg, and his pulse rate was irregular at 40/min. He was disoriented and his speech was dysarthric. Twelve-lead electrocardiography revealed a complete atrioventricular block, with a nodal escape rhythm of 40/min and diffuse ST depression. The presumptive diagnosis of acute oleander intoxication was confirmed by the detection of digoxin (1.0 nmol/L [0.8 ng/mL]) on radioimmunoassay. Despite intensive therapy, the patient's hemodynamic condition deteriorated. His blood pressure decreased to 70/40 mm Hg; he became oliguric and nonresponsive to external stimuli; and his potassium concentration rose to 6.8 mmol/L. Eighteen hours after admission, an empiric 480-mg dose of digoxin-specific Fab antibody fragments was administered intravenously over 30 minutes. Within minutes of the initiation of immunotherapy, the patient woke up; his blood pressure rose to 90/50 mm Hg; and he regained a sinus rhythm of 68/min with a prolonged PR interval. His potassium concentration decreased to 5.1 mmol/L within 15 minutes and normalized within 1 hour of therapy initiation. One day later, the 1 degree atrioventricular block disappeared, but the ST depression persisted for an additional 6 days. The value of digoxin-specific Fab antibody fragments in the treatment of plant glycoside and, in particular, oleander intoxication is discussed.
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PMID:Beneficial effect of digoxin-specific Fab antibody fragments in oleander intoxication. 757 73

Patients often present to the surgeon with abdominal pain, tenderness, and fever. Many exhibit progressive sepsis due to abdominal pathology. Delay in diagnosis and treatment often occurs due to the use of multiple, time-consuming, expensive diagnostic studies. We delineate the use of diagnostic laparoscopy in subsets of patients in whom confusion exists as to the cause of abdominal sepsis--i.e., females in child-bearing years, elderly patients, obese patients, immunosuppressed patients, and patients with suppression of physical findings. The methodical assessment of the entire abdominal cavity is performed utilizing manipulation of the patient's position (Trendelenburg, supine, reverse Trendelenburg, left side up, right side up) and meticulous inspection of the entire small bowel. Diagnoses included acute appendicitis, gangrenous appendicitis, perforated appendicitis with peritonitis or abscess, gangrenous cholecystitis, ischemic bowel disease, perforating carcinoma of the colon, perforating diverticulitis with abscess or peritonitis, tubo-ovarian abscess, closed-loop small-bowel obstruction, megacolon, and perforation of the colon. Laparoscopic treatment of 96% of the patients was performed successfully and a laparoscopic-assisted approach was used in the remainder. There was one mortality (cardiac) and no major morbidity. The development of a Formal Diagnostic Exploratory Laparoscopic (FDEL) approach has aided in the assessment of each of the diagnoses of sepsis in the abdominal cavity. The diagnostic and therapeutic approach laparoscopically avoids extensive preoperative studies, avoids delay in operative intervention, and appears to minimize morbidity and shorten the postoperative recovery interval.
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PMID:Use of laparoscopy in the diagnosis and treatment of patients with surgical abdominal sepsis. 759 89

The safety of AmBisome was evaluated in 187 transplant recipients treated for 197 episodes. Patients included 89 bone marrow transplant recipients, 64 liver transplant recipients, 20 renal transplant recipients and 14 recipients of combined organs. AmBisome was instituted for verified invasive fungal infection in 34 cases, suspected invasive fungal infections in 80 cases and as prophylaxis in 83 cases. AmBisome was given for a median of 11 days (range 1-112 days) with a maximum daily dose of 1.49 +/- 0.70 mg/kg/day (mean +/- SD). The total cumulative dose of AmBisome was 1.11 +/- 1.78 g (mean +/- SD). Side-effects definitely attributed to AmBisome therapy included low potassium (n = 3), low back pain (n = 3), dyspnoea (n = 2), allergic rash (n = 1), nausea and vomiting (n = 1), confusion (n = 1), rise in alkaline phosphatase (n = 1) and cholecystitis (n = 1) with an overall incidence of 13 of 197 (7%). AmBisome was discontinued due to side-effects in 6 (3%) of the cases. During AmBisome treatment the mean cyclosporin dose was 9.6 +/- 28.8 mg/kg/day. Compared to pre- and post-AmBisome therapy there was a significantly increased cyclosporin concentration in blood during AmBisome therapy. Side-effects with possible association to AmBisome therapy included low serum potassium (36%), increase in serum creatinine (31%), rise in alkaline phosphatases (26%) and fever (3%). The overall mean increase in serum creatinine was 20%. Other possible side-effects like headache, abdominal pain, rash, rise in bilirubin, cramps and pancreatitis was seen in single patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Safety of liposomal amphotericin B (AmBisome) in 187 transplant recipients treated with cyclosporin. 770 25


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