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Query: UMLS:C0000737 (
abdominal pain
)
31,184
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Diabetic ketoacidosis is a major source of morbidity and mortality in children and adolescents with
type I diabetes mellitus
. Although diabetic ketoacidosis is often associated with dehydration and electrolyte disturbances, cases with gastrointestinal tract complications due to shock remain particularly unusual. Herein, we reported on a five-year-old girl who had severe diabetic ketoacidosis complicated by hypovolemic shock. Her
abdominal pain
and acidosis despite vigorous fluid resuscitation and insulin therapy failed to improve. Further investigations showed intestinal problem. At laparatomy gangrenous bowel--about 20 cm long--near the distal ileum was found. Entrectomy and ileo-jejunal anastomosis was done and the child survived.
...
PMID:Ischemic intestinal necrosis in a five-year-old girl with diabetic ketoacidosis. 1790 62
There are several surgical complications which can occur following simultaneous pancreas-kidney transplantation (SPKT). Although intestinal obstruction is known to be a common complication after any type of abdominal surgery, the occurrence of small bowel volvulus, which is one of the rare causes of intestinal obstruction, following SPKT has not been published before. A 24-year-old woman suffering from
type I diabetes mellitus
with complications of nephropathy resulting in end stage renal disease (ESRD), neuropathy and retinopathy underwent SPKT. On the postoperative month 5, she was brought to the emergency service due to abdominal distention with mild
abdominal pain
. After laboratory research and diagnostic radiological tests had been carried out, she underwent exploratory laparotomy to determine the pathology for acute abdominal symptoms. Intra-operative observation revealed the presence of an almost totally ischemic small bowel which had occurred due to clockwise rotation of the mesentery. Initially, simple derotation was performed to avoid intestinal resection because of her risky condition, particularly for short bowel syndrome, and subsequent intestinal response was favorable. Thus, surgical treatment was successfully employed to solve the problem without any resection procedure. The patient's postoperative follow-up was uneventful and she was discharged from hospital on postoperative day 7. According to our clinical viewpoint, this study emphasizes that if there is even just a suspicion of acute abdominal problem in a patient with SPKT, surgical intervention should be promptly performed to avoid any irreversible result and to achieve a positive outcome.
...
PMID:Management of small bowel volvulus in a patient with simultaneous pancreas-kidney transplantation (SPKT): a case report. 1790 65
We report the case ofa 16 year old boy who presented with 8 months history of weight loss, 3 months history of polydypsia, polyuria and polyphagia. The child had poor growth since age of 5 years, during which time he developed recurrent
abdominal pain
for 4 years. A diagnosis of chronic calcific pancreatitis complicated by stunting and diabetes mellitus was made on the basis of weight/height ratio less than 5th NCHS percentile for his age, fasting blood sugar of 233mg/dl, and presence of calcifications over the pancreatic area on a plain abdominal X-ray. This case is reported due to the rarity of this condition in children. It is also the first to be seen in our hospital. It will serve to alert the Paediatrician to such clinical condition in children with chronic
abdominal pain
. In this case, symptoms of diabetes mellitus were the reasons for seeking medical attention and it also shows how chronic pancreatits led to
insulin dependent diabetes mellitus
.
...
PMID:Chronic calcific pancreatitis presenting with stunting and diabetes mellitus. 1914 Mar 64
It is known that
type 1 diabetes
mellitus (type 1 DM) may be associated with other autoimmune diseases. Recently, a patient with an association of type 1 DM and familial Mediterranean fever (FMF) was reported in the medical literature. A 10.5-year-old boy was brought to our clinic with complaints of polydipsia, polyuria and weight loss and was diagnosed as diabetic ketoacidosis due to autoimmune type 1 DM. Insulin therapy was started. Elevated thyroid antibodies associated with diffuse goiter and hypothyroidism led to the diagnosis of autoimmune thyroid disease (ATD), and elevated antiendomysial antibodies and abnormal intestinal biopsy findings led to the diagnosis of celiac disease (CD). L-thyroxine therapy and gluten-free diet were initiated accordingly. At the third-year of follow-up, acute attacks of fever,
abdominal pain
and chest pain developed. Laboratory investigations, which were normal between the attacks, revealed elevated erythrocyte sedimentation rate, fibrinogen, white blood cell count and pleural effusion on chest X-ray during the attacks. Molecular analysis for FMF revealed compound heterozygous M694I and V726A. The patient responded well to colchicine therapy started at a dose of 1.5 mg/day. We present the second patient with type 1 DM associated with FMF who also had ATD and CD.
...
PMID:Type 1 diabetes mellitus associated with autoimmune thyroid disease, celiac disease and familial Mediterranean fever: case report. 1948 Mar 34
Celiac disease (nontropical sprue) is autoimmune disorder of the intestinal mucose, which usually develops in humans hypersensitive to gluten. The disease can occur at any age, with the greatest occurrence in early adulthood. Besides intestinal symptomatology--
abdominal pain
, diarrhoea and weight loss--celiac disease is often accompanied by extra-intestinal complications including osteopenia or osteoporosis and osteomalacia. Overproduction of cytokines IL-1 alpha, IL-1 beta and TNF-alpha increases bone resorption, which is further accelerated by hyperparathyroidism connected with malabsorption of calcium and vitamin D. Interaction of both these mechanisms activated bone loss. Similarly as the classic (symptomatic) celiac disease, the occult form, commonly seen in the elderly, may be associated with a risk of osteoporosis or osteomalacia related fractures. Diagnosis is based on positivity of IgA and IgG antigliadin and endomysial antibodies and characteristic endoscopic detection of inflammation and atrophy of duodenal mucose. Areal screening of celiac disease in osteoporotic patients is very dubious. However, a methodical examination should be performed in all patients with unexplainable hyperparathyroidism or in those with various autoimmune diseases (
type 1 diabetes
, thyroiditis chronica), or in premenopausal women and men, who did not reach the appropriate peak bone mass. On the other hand, detailed analysis of calcium metabolism, including markers of bone remodlling and X-ray densitometry (DXA), are recommended in all patients with verified celiac disease. The effectiveness of a gluten-free diet and substitution with vitamin D and calcium, or treatment with bisphosphonates are discussed. The promising therapy appears to be new molecules with reparative effect on intestinal mucose such as AT-1001.
...
PMID:[Celiac disease and its relation to bone metabolism]. 1964 5
A 63-year-old male was admitted to our hospital with diabetic ketoacidosis. He had flu-like symptoms 10 days before admission and developed thirst, polyuria and anorexia with 9 kg of body weight loss in a week. Plasma glucose level on admission was 983 mg/dL and HbA1c was 7.5%. Despite high levels of serum pancreatic enzymes, lack of severe
abdominal pain
and no morphological change of pancreas in the abdominal CT scan eliminated the complication of classical acute pancreatitis. These findings suggested the diagnosis of fulminant
type 1 diabetes
. However, urinary and plasma C-peptide levels showed that insulin secretion was not completely depleted at onset. Furthermore, an examination of islet-related antibodies revealed the presence of high titer anti-GAD antibody. His HLA typing showed that DRB1*0901-DQB1*0303 and A24 were present. He has been doing well with continuation of insulin therapy. Over two years after onset, his plasma C-peptide level was gradually lowered, and anti-GAD antibody was still positive. Taken together, this is a rare case of abrupt onset autoimmune
type 1 diabetes
with transient but apparent exocrine pancreatic impairment at onset. Similar cases should be accumulated to clarify pathophysiological similarities and/or differences between fulminant
type 1 diabetes
and abrupt onset autoimmune
type 1 diabetes
.
...
PMID:A case of abrupt onset autoimmune type 1 diabetes mimicking fulminant type 1 diabetes. 1968 7
A 29-year-old woman was diagnosed as having
type 1 diabetes
mellitus and received insulin aspart and NPH insulin (NovolinN). On day 22, she had leg edema and right
abdominal pain
. The serum hepatobiliary enzyme levels were markedly elevated. Computed tomography revealed gallbladder edema. After an injection of human regular insulin and NPH insulin (HumacartN), the elevated liver enzyme levels were no longer observed. Challenge testing demonstrated that protamine was the cause of her allergy. Furthermore, tests revealed increased VEGF levels. This is an extremely rare case with a delayed-type protamine allergy caused by NovolinN resulting in gallbladder edema.
...
PMID:Gallbladder edema in type 1 diabetic patient due to delayed-type insulin allergy. 1972 1
We describe an acute onset of diabetes mellitus during third trimester of pregnancy revealed by ketoacidosis, complicated by fetal death, which could evoke fulminant
type 1 diabetes
, a novel subtype of
type 1 diabetes
first described in Japan and rarely described in Caucasian people. Diagnosis of diabetic ketoacidosis could be made on simple signs as
abdominal pain
, vomiting or ketone bodies on urinary multistix. Capillary glycaemic control is necessary to distinguish fast from ketoacidosis. The treatment of this severe imbalance must be initiated in emergency.
...
PMID:[Ketoacidosis complicated by fetal death revealing fulminant diabetes during the third trimester of pregnancy]. 2062 14
This study describes the profile of 100 cases of diabetic ketoacidosis (DKA) at a teaching hospital in 1 Benghazi, Libyan Arab Jamahiriya. DKA was more frequent in young women with
type 1 diabetes
and mostly due to preventable causes, e.g., disrupted insulin treatment and/or infection. DKA also occurred in type 2 diabetics, with a higher mortality rate, as they were older patients with co-morbidity. Polyurea, fatigue,
abdominal pain
and vomiting were the most common clinical features, while coma was rarer. A high number of cases were first presentations of
type 1 diabetes
; hence this diagnosis should be considered in all patients with acute abdomen or decreased level of consciousness. The reasons for high mortality rate in this study (10%) were multifactorial.
...
PMID:Profile of diabetic ketoacidosis at a teaching hospital in Benghazi, Libyan Arab Jamahiriya. 2079 43
Although complications including graft thrombosis, graft pancreatitis, and rejection have been well documented after pancreas transplantation, the occurrence of graft duodenal perforation is uncommon. In this article, we report a case of graft duodenal perforation due to internal hernia after simultaneous pancreas-kidney transplantation (SPK). A patient with
type I diabetes mellitus
and diabetic nephropathy had undergone SPK from a cadaveric donor. One year later, she was admitted to our hospital for severe lower
abdominal pain
with preshock status. She was immediately examined by abdominal computed tomography and both peripancreas graft fluid accumulation and severe dilatation of the ileum were detected. On emergency operation, two punched holes located at the graft duodenal side near the suture line and an obstruction of herniated bowel behind the graft pancreas were detected. These holes were repaired and the internal hernia was reduced. However, a control of the intraabdominal infection was very difficult despite intensive treatment with antibiotics and additional abdominal drainage. Finally, a graft pancreatectomy was unavoidably required. When complications, including symptomatic intraabdominal infection, require re-laparotomy after pancreas transplantation, the therapeutic focus should be switched from salvaging the graft to the preservation of life.
...
PMID:Graft Duodenal Perforation due to Internal Hernia after Simultaneous Pancreas-Kidney Transplantation: Report of a Case. 2149 Aug 95
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