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

Renal TB is difficult to diagnose, because many patients present themselves with lower urinary symptoms which are typical of bacterial cystitis. We report a case of a young woman with renal TB and ESRD. She was admitted with complaints of adynamia, anorexia, fever, weight loss, dysuria and generalized edema for 10 months. At physical examination she was febrile (39 degrees C), and her abdomen had increased volume and was painful at palpation. Laboratorial tests showed serum urea = 220 mg/dL, creatinine = 6.6 mg/dL, hemoglobin = 7.9 g/dL, hematocrit = 24.3%, leukocytes = 33,600/mm(3) and platelets = 664,000/mm(3). Urinalysis showed an acid urine (pH = 5.0), leukocyturia (2+/4+) and mild proteinuria (1+/4+). She was also oliguric (urinary volume < 400 mL/day). Abdominal echography showed thick and contracted bladder walls and heterogeneous liquid collection in the left pelvic region. Two laparotomies were performed, in which abscess in pelvic region was found. Anti-peritoneal tuberculosis treatment with rifampin, isoniazid and pyrazinamide was started. During the follow-up, the urine culture was found to be positive for M. tuberculosis. Six months later the patient had complaints of abdominal pain and dysuria. New laboratorial tests showed serum urea = 187 mg/dL, creatinine = 8.0 mg/dL, potassium = 6.5 mEq/L. Hemodialysis was then started. The CT scan showed signs of chronic nephropathy, dilated calyces and thinning of renal cortex in both kidneys and severe dilation of ureter. The patient developed neurologic symptoms, suggesting tuberculous meningoencephalitis, and died despite of support measures adopted. The patient had ESRD due to secondary uropathy to prolonged tuberculosis of urinary tract that was caused by delayed clinical and laboratorial diagnosis, and probably also due to inadequate antituberculous drugs administration.
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PMID:End-stage renal disease due to delayed diagnosis of renal tuberculosis: a fatal case report. 1762 50

Lupus cystitis is a rare manifestation in systemic lupus erythematosus (SLE); it usually occurs in association with gastrointestinal manifestations. We report two cases of lupus cystitis without bladder irritation symptoms. Both cases developed severe abdominal pain, nausea, and diarrhea and showed no bladder irritation symptoms. The diagnosis of lupus cystitis was made by abdominal ultrasonography and bladder biopsy. The patients were treated with intravenous methylprednisolone pulse therapy followed by oral prednisolone. Their symptoms were ameliorated, and hydroureteronephrosis improved. Thus, when a patient with SLE shows gastrointestinal symptoms, further examinations are required to determine whether the patient has lupus cystitis.
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PMID:Two cases of lupus cystitis with no bladder irritation symptoms. 1870 58

We describe a case of simultaneous severe lupus enteritis and lupus cystitis in a 38-year-old female with a 21-year history of systemic lupus erythematosus (SLE). The patient presented with acute abdominal pain, decreased urinary output, associated low-grade fever, nausea, and diarrhea. She had serologic evidence of an SLE flare with acute renal insufficiency. Computed tomography examination revealed dramatic edema of the large- and small-bowel walls with no evidence of bowel loop dilatation or pneumatosis intestinalis, marked diffuse thickening of the urinary bladder wall, and bilateral hydronephrosis and hydroureter. Lupus enteritis and lupus cystitis were diagnosed and treatment with intravenous corticosteroids led to prompt resolution of the abdominal pain and normalization of renal function. Because infarction of tissue and bowel rupture are potentially fatal complications, it is essential to consider lupus enteritis in SLE patients who present with abdominal pain. This case demonstrates that once lupus enteritis is suspected, coexistent lupus cystitis must also be considered.
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PMID:Recognizing concomitant lupus enteritis and lupus cystitis. 1876 23

We present an interesting case of bladder necrosis in an 11-year-old boy with sickle-cell disease. The patient initially presented with sudden onset of abdominal pain and went on to have gross hematuria with clots and severe dysuria. Cysto-urethroscopy revealed global hemorrhagic cystitis and a suprapubic catheter was inserted percutaneously during cystoscopy. The symptoms spontaneously resolved over several weeks and the child voids normally at last follow-up. Multiple bladder biopsies were taken and all were completely necrotic.
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PMID:Bladder necrosis presenting with hematuria in a patient with sickle-cell disease. 1894 34

It is postulated that gas-forming organisms ferment glucose within the wall of the urinary bladder leading to air collection; emphysematous cystitis occurs due to the fermentation of glucose by these organisms. Emphysematous cystitis is a rare condition usually seen in patients who are either diabetic or have other immunosuppressive diseases, or have had disruption of the bladder wall due to trauma or surgical instrumentation. We present a case of emphysematous cystitis in a patient with cystic fibrosis without any other underlying immunosuppressive conditions which, to our knowledge, is the first reported case. The patient presented with abdominal pain and was diagnosed with abdominal computed tomography examination. She was managed conservatively with a favorable outcome.
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PMID:A case of emphysematous cystitis in cystic fibrosis. 1907 75

A 24-year-old woman having two children using an intrauterine contraceptive device was admitted with lower abdominal pain and fever. On clinical and radiographic examination revealed a 7x6 cm multi-loculated cystic mass in the lower abdomen. The differential diagnosis included twisted ovarian cyst, ectopic pregnancy, tubercular tubo-ovarian (TO) mass red degeneration fibroid, diverticular diseases, emphysematous cystitis, pelvic malignancy, and mesenteric cyst. On histologic examination, an actinomycotic TO abscess was found with sulfur granules.
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PMID:Pelvic actinomycosis: a rare entity presenting as tubo-ovarian abscess. 1952 54

THIS CASE REPORT DESCRIBES AN ATYPICAL PRESENTATION OF AN ATYPICAL DISEASE ENTITY: Emphysematous Cystitis, a rapidly progressive, ascending urinary tract infection, in an emergency department (ED) patient whose chief complaint was abdominal pain and who had a urinalysis not consistent with the diagnosis of cystitis.
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PMID:A Case of Complicated Urinary Tract Infection: Klebsiella pneumoniae Emphysematous Cystitis Presenting as Abdominal Pain in the Emergency Department. 1956 37

We present a case of a 28-year-old black female patient with a previous diagnosis of overlapping syndrome of lupus and rheumatoid arthritis, treated with corticosteroids and methotrexate, who was admitted to our department due to abdominal pain with vomits and diarrhea for 15 days. On complementary evaluation elevated C-reactive protein and erythrocyte sedimentation rate, lactate dehydrogenase and amylase levels were detected, C3 was reduced, blood, faeces, peritoneal fluid and urine cultures were negative; abdominal computerized tomography disclosed jejunal thickening with parietal edema, bilateral ureterohydronephrosis and bladder parietal thickening; on endoscopy with biopsy there was chronic pangastritis and duodenitis; cystoscopy with biopsy showed chronic cystitis. Those aspects suggested lupus enteritis and cystitis which appear rarely associated and have poor prognosis. This patient was treated with high dose corticosteroids followed by azathioprine and prednisolone, with clinical and imaging improvement.
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PMID:[Enteritis and cystitis - a cause of abdominal pain in lupus]. 1956 79

A case of nephrotic syndrome associated with bilateral hydronephrosis in a 26-year-old female is reported. She was referred to our hospital because of persistent diarrhea, abdominal pain, and urinary disorders. On admission, ascites, intestinal edema, and bilateral hydronephrosis, were demonstrated by radiographic analysis. The findings of both physical and laboratory examinations showed evidence of systemic lupus erythematosus (SLE). In addition, diffuse proliferative lupus nephritis was consistently confirmed by a renal biopsy. Immediately after the initiation of steroid treatment, her abdominal symptoms disappeared followed by an improvement in the symptoms of intestinal edema, hydronephrosis, and the renal function. The relationship between ureterohydronephrosis and lupus cystitis, and the fact that lupus enteritis is often associated with lupus cystitis have been demonstrated by previous studies. Finally, the clinical manifestations observed in our case led us to consider the association of lupus enteritis and cystitis. We should bear in mind the possible association of several disorders, including nephrotic syndrome, enteritis, and hydronephrosis due to cystitis, in cases presenting with SLE.
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PMID:[Case of lupus nephritis and enteritis associated with bilateral hydronephrosis]. 1971 66

We present the case of a 57-year-old man with emphysematous cystitis. The patient presented with a complaint of several days of lower abdominal pain and gross hematuria. Work-up included an abdominal CT scan that revealed gas within the urinary bladder wall, and cystoscopy confirmed diffuse submucosal emphysema throughout the bladder. The patient was treated conservatively with broad spectrum antibiotics, with prompt resolution of both symptoms and radiographic findings. Emphysematous cystitis is a rare clinically entity, more commonly seen in diabetic, immunocompromised patients. A conservative treatment approach using antibiotics and bladder catheterization is typically successful, with a complication rate of only 18.8%.
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PMID:Emphysematous cystitis. 1985 75


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