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

Of 6,099 children treated for malignancy, 16 (ages 3.5 to 18 years) developed acute appendicitis between 1962 and 1989. Fourteen had leukemia (ALL 10, AML 4). One each had rhabdomyosarcoma and Ewing's sarcoma. Active malignancy at diagnosis was noted in 10, 4 of whom had severe neutropenia (absolute neutrophil count less than 500/mm3). Of all the leukemics (2,794/6,099), abdominal pain during induction was a frequent complaint. The incidence of appendicitis, however, was low (0.5%). Nine of the 16 patients presented classically, facilitating prompt diagnosis and treatment. Six diagnoses were delayed. Three of these patients presented atypically with vague, nonlocalized pain, abdominal distention, lack of abdominal guarding, fever, dehydration, diarrhea, and unusual symptoms such as upper gastrointestinal bleeding. In each of these 6 patients the appendix was ruptured. Delays led to complications and deaths. Three patients required perioperative transfusions to treat excessive bleeding and two patients with ruptured appendicitis developed wound abscesses. Two patients died; in one, ruptured appendix was diagnosed only at autopsy. The other patient died of uncontrolled sepsis. Typhlitis occurring during induction chemotherapy may present similarly and is the main differential diagnosis. Typhlitis will usually improve with medical treatment alone. Nausea and vomiting (13/16), right lower quadrant pain (13/16), guarding (14/16), tachycardia (12/16), fever (10/16), and rebound tenderness (10/16) were the most frequent signs and symptoms of appendicitis. Persistent localized abdominal pain and guarding, lack of improvement with medical treatment, clinical deterioration, and the development of a mass were our indications for laparotomy. Despite major improvements in therapy, there is still a 37.5% error rate in our ability to accurately diagnose appendicitis in pediatric cancer patients.
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PMID:Acute appendicitis in children with leukemia and other malignancies: still a diagnostic dilemma. 152 62

An adult Basset Hound was examined because of acute vomiting, signs of depression, dehydration, and signs of abdominal pain. Radiography revealed a soft tissue dense mass in the stomach. At exploratory laparotomy, 75% of the stomach was black, and the pylorus, proximal portion of the duodenum, and pancreas were found inverted into the stomach. The dog was euthanatized.
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PMID:Idiopathic, duodenogastric intussusception in an adult dog. 177 46

Between October 1987 and March 1988, research assistants used the explanatory model interview for classification to interview households in 2 villages in Banna subdistrict and 3 villages in Sam-Tai subdistrict in Ayutthaya province, Thailand. Researchers analyzed the data to examine the respondents' diarrhea-related perceptions, beliefs, and practices. The people used 12 terms for diarrhea. The mean number of terms/person was 6. Everyone used the term tong-sia (generic diarrhea). The Ministry of Public Health used the term ahiwa (severe diarrhea such as cholera) in its health education campaigns but only 39.3% of the people knew this term. 99.1% attributed a transitional phase in normal growth and development to be the cause of taae-tua. Bad child's and mother's food was frequently perceived as the cause of ahiwa, tong-sia, and bid (colicky abdominal pain). Everyone, 93.1%, and 67.5% mentioned flies and germs (sanitation and hygienic practices) as the cause of ahiwa, tong-sia, and bid, respectively. The responses were different between theory and actual practice, however. For example, 91% believed bad food and poor sanitation and hygiene were responsible for tong-sia, but only 34.4% gave this response when referring to index cases. Few people attributed supernatural causes or sorcery to bring about diarrhea illness. Most villagers were impressed with modern drugs and injections but they did not understand their nature. They sought treatment from professional sources that should know appropriate diarrhea treatment but did not. Only 51% used oral rehydration solution (ORS) to treat diarrhea and just 3.5% of them believed ORS to be the most useful treatment. Health education efforts should include descriptions of cholera rather than using the work ahiwa, emphasis on the need to treat diarrhea regardless of its perceived cause, promotion of improved sanitation and hygiene, and communication of appropriate expectations of ORS and its ability to prevent and ameliorate dehydration and reduce mortality.
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PMID:Cultural study of diarrhoeal illnesses in central Thailand and its practical implications. 178 75

Escherichia coli isolated from 389 children, less than 1-year of age with diarrhoea, were analyzed for the presence of Enteroaggregative E. coli (EAggEC) by their pattern of adherence to HeLa cells. EAggEC were isolated from 58 (14.8%) children either as a sole pathogen or in combination with other enteric pathogens. In 60% of these children EAggEC infection occurred in the second half of infancy (7-12 m). Thirty-eight of 47 children having EAggEC as a sole pathogen had watery diarrhoea along with vomiting (87%) and dehydration (74%). In contrast, 9 of the 47 cases had mucoid diarrhoea with infrequent vomiting and dehydration and frequent abdominal pain. Children infected with EAggEC were successfully rehydrated with oral rehydration solution (ORS) alone. Seventy-one percent of the EAggEC strains were resistant to more than three antibiotics. It was evident by phage pattern that various EAggEC strains were present in the population. The results indicated that infections with EAggEC may have a role in the development of diarrhoea among children less than 1-year of age in Bangladesh.
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PMID:Enteroaggregative Escherichia coli infections in Bangladeshi children: clinical and microbiological features. 180 May 63

Acute posttraumatic and postoperative cholecystitis is a serious and life-threatening complication with mortality rates ranging from 10 to 50%. The pathogenesis is multifactorial: possible reasons are blood transfusions, dehydration, narcotics, shock and positive end-expiratory pressure (PEEP). Between 1980 and 1990 12 patients underwent surgery for acute cholecystitis. Six of them suffered from a so-called acute acalculous cholecystitis. Two patients died postoperatively. The symptoms are that of a "common" cholecystitis with leukocytosis, fever, abdominal distension and upper right abdominal pain. Sonography is a good method to establish the diagnosis and helps in the decision for cholecystectomy. Clinicians must remember the possibility of an acute cholecystitis in any surgical patient developing abdominal pain or unexplained fever.
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PMID:[Acute stress-induced cholecystitis]. 187 Mar 63

Between August 24-October 20, 1985, an outbreak of acute diarrheal disease occurred among 1833 children in Imphal, Bishenpur, and Thoubal districts in Manipur State in India for an overall attach rate of 2/1000. 17 children died, a case fatality rate of 9/1000. Hospital and health center personnel treated 1711 cases with rehydration therapy (oral or intravenous fluids). Local, mainly unqualified, practitioners treated the remaining 122 cases with antidarrheal drugs. Children treated at home were more likely to die than those treated at health facilities (case fatality rates 0.6% vs. 4.9%; p.001). Nevertheless these case fatality rates were lower than those in a 1973-1974 outbreak of gastroenteritis in Manipur, perhaps because the health authority distributed oral rehydration solution packets during this 1985 epidemic. The leading symptoms were watery diarrhea (82.5%), vomiting (67.5%), and abdominal pain (37.5%). Children 5 years old tended to experience severe dehydration more so than younger children (31.3% vs. 12.5%). 58.8% of hospitalized cases were older children who suffered the highest death rate. (1.9%). Peak admissions occurred the last week of September ending on October 2. Yet during the decline phase, the admission rate of children 2 years old rose. 25.3% of cases sampled recovered V. cholerae with the highest isolation rate (30.8%) found in older children and adults. 50% of fecal samples of children 6-23 months old tested positive for rotavirus. The researchers did not find any obvious epidemiological link between the 3 areas. They concluded that the rotavirus epidemic which peaked the week after that of cholera represented the beginning of the usual rotavirus diarrhea season.
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PMID:Report of an outbreak of diarrhoeal disease caused by cholera followed by rotavirus in Manipur. 210 90

Four cases of diabetic ketoacidosis presenting with abdominal pain are reported. Case 1: a 14-year-old boy suffered from sudden onset of mid-abdominal pain, then migrating to the right lower quadrant. Nausea and vomiting occurred subsequently. Appendectomy was performed under the impression of acute appendicitis in an outside surgical clinic. The patient became comatose the next day and then was transferred to our hospital. Diabetic ketoacidosis was diagnosed after the detection of hyperglycemia, glycosuria, and ketonuria on the day of admission. Unfortunately, he expired on the same day in spite of vigorous resuscitation. Case 2: a 9-year-old boy complained of abdominal pain for 10 days. There was no specific finding in the physical examination. Diabetic ketoacidosis was confirmed four days later when conscious disturbance, dehydration, and tachypnea were noticed. Case 3: a 10-year-old girl presented with a history of intermittent abdominal pain for one month. The character of the abdominal pain was nonspecific. Glycosuria was detected in a pediatric clinic. Diabetic ketoacidosis was confirmed after her referral to our hospital. Case 4: a 5-year-old girl suffered from acute abdominal pain for four hours. She was found to have tachypnea, lethargy, and ill-looking. Diabetic ketoacidosis was diagnosed after serial examinations. The abdominal pain in diabetic ketoacidosis may lead the pediatrician into diagnostic error. Therefore, when a child presented with non-specific abdominal pain, a routine urine sugar should be checked in order not to miss the possibility of diabetic ketoacidosis.
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PMID:[Abdominal pain in diabetic ketoacidosis: report of four cases]. 212 98

The prevalence of Aeromonas spp. and other enteric pathogens in stool specimens from diarrheic and non-diarrheic patients was studied over a 12 month period (January to December, 1986). Except for the absence of fever, all the clinical features in Aeromonas diarrhea were comparable to those associated with other diarrheagenic agents. These features included abdominal pain (30%), vomiting (24.5%), fever (31.5%), dehydration (9.5%) and hematochezia (19.5%). Aeromonas spp. were more frequently isolated from patients with gastroenteritis (2.5%) than from control patients (1.0%) (P less than 0.05). Isolates were recovered more often during the dry months (66.7%), than during the wet months (33.3%). Among the enteric pathogens isolated, Aeromonas spp. (2.5%) ranked next to Esch. coli (14.5%) and Shigella spp. (6.3%) in prevalence. Other bacterial isolates included Plesiomonas shigelloides (1.5%) Vibrio spp. (1.0%), Yersinia enterocolitica (1.0%) and Salmonella spp. (1.8%).
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PMID:Comparative study of the prevalence and clinical profiles of diarrheas due to Aeromonas and other enteric pathogens. 221 40

During an 18 months' survey of children admitted to hospital with gastroenteritis, oocysts of the protozoan Cryptosporidium were detected in 35 cases (1.6% of the total 2205 surveyed). The affected children (age range 5 months to 8 years; mean 34.2 months) were immunocompetent, and had green and offensive watery diarrhoea. Vomiting (94%) with dehydration (80%), fever (66%) and abdominal pain (26%) were major clinical features of the diarrhoeal illness which lasted a mean 8.2 (range 3-14) days. Five children were infected with other enteropathogens. The illness was self-limiting in all cases and none were excreting oocysts 2 weeks after cessation of diarrhoea. Peak incidence occurred during the months of March and April, with no cases during the hottest months of July and August. There was no known contact with animals or pets; 4 children had other siblings affected and 2 conformed to cases of travellers' diarrhoea. The significance of cryptosporidiosis in Kuwait and the need for epidemiological studies are discussed.
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PMID:Cryptosporidium gastroenteritis in immunocompetent children from Kuwait. 226 Feb 6

Ten hospitalized patients with severe diarrhea associated with intestinal Candida overgrowth are reported. Candida-associated diarrhea is predominantly of the secretory type, characterized by frequent watery stools, usually without blood, mucus, tenesmus, or abdominal pain. The patients were elderly, malnourished, and critically ill, or suffered from chronic debilitating illness. Their hospital stays were prolonged, and the majority were being treated with multiple antibiotics or chemotherapeutic agents. Diarrhea often led to dehydration, prerenal azotemia, hyperchloremic metabolic acidosis, and electrolyte imbalance. Stool culture most frequently isolated Cand. albicans in association with decreased normal flora. Colonoscopy showed no evidence of colitis. Diagnosis was made based on the absence of diarrhea-producing medications, the continuation of diarrhea despite fasting, the exclusion of other infections, inflammatory conditions and other causes of secretory diarrhea, and a dramatic response to a short course of nystatin.
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PMID:Candida-associated diarrhea in hospitalized patients. 229 77


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