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 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The name juvenile tropical pancreatitis syndrome (JTPS) is proposed for a disease which affects young people of both sexes in certain parts of the tropics and which is characterised by abdominal pain, diabetes, steatorrhoea, and pancreatic calcification. The condition seems to start with blockage of the pancreatic ducts by laminated secretions or inspissated mucus plugs which later calcify. Chronic pancreatitis follows. The hypothesis is that plugs are the result of pancreatic stasis due to prolonged lack of food in the stomach and/or gastroenteritis and dehydration. Most plugs are probably dislodged during convalescence when protein-containing foods are eaten and stimulate vigorous flow of pancreatic juice. The sluggish pancreatic flow produced by very-low-protein diets may not dislodge plugs. Repeated infection and anorexia can enlarge the plugs which ultimately calcify. JTPS therefore occurs in Third-World areas with a high rate of childhood infections, and where low-protein staples are taken. Cereal staples seem to reduce the incidence of JTPS in endemic areas because of their protein content.
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PMID:Pathogenesis of juvenile tropical pancreatitis syndrome. 610 87

Alcoholic ketoacidosis is a common condition which occurs predominantly in chronic alcoholics. The usual picture is an interval of increased ethanol intake followed by one or more days of abdominal pain, vomiting, dehydration and a marked decrease in caloric intake. Acidosis is frequently as severe as in diabetic ketoacidosis, but the serum Acetest measurement of ketones may be negative or only slightly positive because of the predominance of beta-hydroxybutyrate compared with acetoacetate. Treatment with intravenous glucose and saline are the essentials of management. Insulin, bicarbonate and phosphate are usually not needed. The major cause of morbidity and mortality is not the acidosis but rather failure to adequately treat concurrent medical or surgical conditions.
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PMID:Alcoholic ketoacidosis: clinical and laboratory presentation, pathophysiology and treatment. 634 51

A 12-yr-old girl was admitted for evaluation of a 5-wk history of increasing abdominal pain. She also reported a history of constipation since birth requiring chronic laxative use. Occasional bouts of abdominal distention and vomiting resulted in dehydration necessitating hospitalization. Two previous laparotomies had identified an apparent obstructing angulation of the ascending colon. Rectal biopsy specimens obtained on this admission failed to reveal any ganglion cells. Sequential biopsy specimens of the entire colon obtained at laparotomy also failed to reveal any ganglion cells. Ganglion cells were found in the distal ileum. A total colectomy was performed. Three previously reported cases of total colonic aganglionosis initially diagnosed in older patients are reviewed. Similarities included nonspecific radiographic findings, a history of constipation since birth, and initial laparotomies revealing spurious causes of bowel obstruction.
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PMID:Total colonic aganglionosis initially diagnosed in an adolescent. 648 1

During a 10 months' survey of children with gastro-enteritis, 27 cases of cryptosporidiosis (1.4% of those tested) were found. Only one patient was infected with another potential enteropathogen. In most cases the faeces were described as green, watery and offensive. Clinical features also included anorexia, vomiting and abdominal pain. The diarrhoea was moderate to severe in 15 cases and resulted in dehydration in 9 patients of whom two were more than 5% dehydrated. The diarrhoea was prolonged and persisted on average for 13 days. Excretion of oocysts did not stop with cessation of diarrhoea but continued for a further 11 days. Human beings appeared to be as important a source for Cryptosporidium as animals and it seemed possible that patients were infective throughout the period that they were excreting oocysts.
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PMID:Gastro-enteritis due to Cryptosporidium: a prospective survey in a children's hospital. 654 23

From among 1,248 stool specimens examined during the 2-year period, February 1979 to February 1981, astrovirus was detected by electron microscopy in 42 specimens from 28 children. Diarrhoea was an invariable clinical feature; vomiting occurred in 18 children, abdominal pain in 7, and mild dehydration in 5. Fourteen of the children with acute diarrhoea were admitted directly to the gastroenteritis unit. The other 14 children developed their acute diarrhoea sometime after hospital admission. Although the excretion of astrovirus was associated with mild gastroenteritis, the presence of other enteric pathogens in 16 of the 28 children limited the degree to which the clinical symptoms could be attributed to astrovirus alone. Transient monosaccharide intolerance lasting 1 to 2 days occurred in 18 children, and cow's milk protein intolerance requiring milk elimination for several months was a sequel in 3 children.
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PMID:Clinical associations of stool astrovirus in childhood. 682 Nov 17

The epidemiologic and clinical characteristics of 412 patients infected with Shigella from a systematic sample of approximately 100,000 patients attending Dacca Hospital, International Centre for Diarrhoeal Disease Research, Bangladesh, between December 1, 1979, and November 30, 1980, were reviewed. Shigella was isolated from 11.6% of the 3,550 patients in the sample and was the second most common isolate in patients over two years old. Two clinical presentations of shigellosis were found: (I) watery diarrhea occurring in younger children and associated with a shorter duration of illness and with more vomiting and dehydration and (2) dysentery with stool blood and abdominal pain. These different presentations may reflect two mechanisms in the pathogenesis of shigellosis or different stages of the disease. The most useful signs and symptoms for the diagnosis of shigellosis were stool with blood and abdominal pain in all patients and the absence of watery diarrhea and vomiting in patients over one year old. Simple visual inspection of stool for blood correctly identified 44% of all patients infected with Shigella.
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PMID:Epidemiologic and clinical features of patients infected with Shigella who attended a diarrheal disease hospital in Bangladesh. 710 70

An elderly woman with a history of cardiac failure treated with digitalis had both abdominal pain and dehydration. Parenteral fluid and electrolyte support failed to alleviate abdominal pain. Superior mesenteric arteriography combined with "spillover" method of estimating blood flow revealed an intestinal nonocclusive ischemic state which was treated successfully with 44-hour intraarterial infusion of prostaglandin E1. Laparotomy performed during the drug infusion revealed viable intestine.
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PMID:Nonocclusive intestinal ischemia treated with intraarterial infusion of prostaglandin E1. 720 Aug 29

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

The role played by Campylobacter jejuni in the origin of infantile bacterial gastroenteritis is important. Diarrhea, often bloody, is dysentery-like. Fever, abdominal pain and vomiting are rarely lacking. Dehydration is exceptional. Spontaneous recovery occurs in about ten days. Campylobacter jejuni is a Gram-negative, oxidase-positive, microaerophilic bacillus. The often typical results of direct morphological examination of the stools, special culture and isolation techniques, the erythromycine sensitivity of the germ, clearly define campylobacteriosis. Its epidemiology is still being investigated.
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PMID:[Infantile digestive campylobacteriosis. Two case studies (author's transl)]. 739 42


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