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

60 patients (p) with ages ranging between 19 and 73 (32 females and 28 males) were selected and randomized for a prospective study about he confirmation of endoscopic wounds reported like giardiasic duodenitis: a nodular whitish puncture over the mucous with a focal or diffuse pattern over. We tested the correlation between the endoscopic findings and the results of histopathology and fecal tests. A duodenoscopy until the second portion was made with an Olympus GIF-Q equipment, 2 biopsies were taken from the duodenal bulb and from the second portion. 45 (p) exhibited a typical aspect before mentioned. In this group we found the protozoa in the biopsies of 35 (p) (77.78%). The fecal test were positive for 22 of these (p) (48.88%) and negative for 23 (51.12%). 15 (p) had a normal duodenoscopy; 13 of these (p) had a negative biopsy (86.66%) and only two cases (13.33%) resulted in a positive biopsy for giardia. The results for the fecal tests were negative in 93.34% (p). The most common symptoms were: upper-abdominal pain (67.50), acidity (62.50%), pyrosis (25%) diarrhea (10%) and constipation (10%). The results of our study confirm that endoscopic lesions of duodenum observed as a whitish nodular puncture, over the mucous with a focal or diffuse pattern were compatible with a duodenitis caused by giardia lamblia. It was confirmed in the majority of cases with biopsy and in almost 50% of fecal test performed.
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PMID:[Giardiasis duodenitis: is the endoscopic diagnosis possible?]. 811 38

Helicobacter pylori gastritis usually manifests as recurrent abdominal pain but is sometimes discovered upon evaluation for digestive tract bleeding with severe anemia. An 11-year-old who was not under medication and had no history of pain was admitted for isolated regenerative anemia (5.6 g/dl) due to digestive tract bleeding. Laboratory tests showed only low serum iron and ferritin levels. Endoscopy disclosed hemorrhagic inflammation of the duodenal cap and antritis with a hillocky appearance. The diagnosis of H. pylori infection was established on the basis of the finding of curved Gram-negative rods on the smears and of a positive urea test. There was moderate interstitial antritis. The patient was given an H2 antagonist (ranitidine) and amoxicillin with tinidazole for six weeks. Serum IgG antibodies against H. pylori were found in the child's parents and siblings, with the exception of a 7 month old infant. A ten year old sister had been hospitalized two years earlier for hemorrhagic duodenitis ascribed at the time to use of acetylsalicylic acid. H. pylori has been reported in 40% to 95% of pediatric patients with primary gastritis. Physicians should be familiar with this frequent, often familial disease. Management rests on concomitant administration of two antimicrobials and an acid secretion inhibitor to the index patient and family members. Endoscopy is too invasive to be appropriate for monitoring the outcome. In practice, recovery is affirmed on the basis of resolution of clinical manifestations and decreased levels of anti-H. pylori antibodies.
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PMID:[Helicobacter pylori gastritis manifested by acute anemia]. 835 98

The relationship between gastric Helicobacter pylori colonization and esophagitis was determined in 457 children undergoing endoscopic evaluation of abdominal pain and/or vomiting. In all patients, biopsies of the esophagus were examined histologically, and two antral biopsies were analyzed for the presence of H. pylori, using standard microbiological and histochemical techniques. The incidence of biopsy-proven esophagitis was similar in H. pylori-positive (15/56 patients) and -negative (94/401; p = NS) groups. Clinical improvement, after 2 months of antisecretory therapy with H2-receptor antagonists, was independent of H. pylori status (11/15 vs. 68/94 responders; p = NS). All 26 H. pylori-negative nonresponders became asymptomatic with a second course of H2-blockers. The 4/15 H. pylori-positive patients (all of whom had associated gastritis/duodenitis) who failed antisecretory therapy responded clinically to treatment with amoxicillin plus bismuth subsalicylate. These data indicate that primary treatment of biopsy-confirmed esophagitis in children should include anti-secretory agents, regardless of H. pylori status. A small percentage of H. pylori-positive patients with esophagitis and concomitant gastroduodenal inflammation may require additional antibacterial therapy, suggesting that presence of the organism should be assessed in all pediatric patients undergoing upper endoscopic evaluation.
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PMID:Esophagitis and Helicobacter pylori in children: incidence and therapeutic implications. 847 Jun 30

Helicobacter pylori has been recognized as a contributing factor in gastrointestinal disease. Yet, questions remain as to its clinical significance. This prospective study was done to determine the prevalence, distribution, clinical significance, and treatment response of H. pylori gastrointestinal infection. A total of 91 patients with upper gastrointestinal symptoms underwent 122 esophagogastroduodenoscopies (EGD). Biopsies were taken for H. pylori from the gastric fundus, body, antrum, prepylorus, and duodenal bulb; 45.3 per cent of patients with abdominal pain, 27.8 per cent with "heartburn," and 55.6 per cent with anemia/GI bleed had H. pylori infections. Pertaining to EGD findings: 54.2 per cent of patients with gastroduodenal ulcer, 56.4 per cent with gastritis/duodenitis, 37.5 per cent with esophagitis/esophageal ulcer, but only 17.6 per cent with normal findings had H. pylori infection. The distribution of H. pylori: fundus (53.3%); body (55.6%); antrum (85.4%); prepylorus (78.4%); duodenum (15.6%). Treatment for H. pylori was amoxicillin, metronidazole, colloid bismuth with an antisecretory drug. H. pylori was eradicated in 78.9 per cent of patients; 93.3 per cent of these patients had symptomatic improvement and/or ulcer healing. Using stepwise logistic regression, H. pylori eradication was an independent predictor of symptomatic improvement.
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PMID:The spectrum of Helicobacter pylori in upper gastrointestinal disease. 854 Jun 48

Food allergy has been implicated lately in the etiopathogenesis of abdominal pain in children, with particular attention pain to gastritis and/or duodenitis. The aim of the study was to analyse the cause-and-effect relationship between chronic abdominal pain in children, endoscopic and histopatological picture, and food allergy, as well as to evaluate the applied elimination diet and/or antiallergic treatment on the improvement of both the clinical status and endoscopic picture. In 71 children gastrofiberoscopic examinations, food skin tests, and specific and total IgE allergen serum tests were performed. In the majority of examined children one could observe an improvement of clinical status and of the endoscopic-histopatological picture of the stomach mucous membrane after application an elimination diet and/or treatment with sodium cromoglycate.
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PMID:[Food allergy in pathogenesis of chronic abdominal pain in children]. 868 58

There is ample empirical evidence supporting the view of emotional disturbances in children with recurrent abdominal pain (RAP) as well as in their parents. However, controlled studies have reported that such manifestations can also be found in patients with other chronic ailments. In order to characterize further the nature of emotional factors in RAP patients, we conducted a controlled psychological evaluation of 46 consecutive new patients with RAP, aged 7-17 years, (group A) by means of structured interviews and questionnaires. Two control groups of pediatric patients with chronic illnesses were also assessed using the same methodology. Group B consisted of 22 individuals with chronic abdominal pain and endoscopy-proven peptic ulcer or duodenitis, and group C consisted of 24 individuals with chronic, stable, non-gastroenterological diseases (e.g., diabetes mellitus or physical handicaps). Parents were evaluated for depressive symptoms. One-way analysis of variance and contingency tables were used for statistical comparisons. There was a higher proportion of female patients in group A than in group B (70 vs 41%; p < 0.05). There were significantly more patients in group A than in group B that reported that their abdominal pain: a) never appeared during sleep, b) began soon after the patient's arousal in the morning, c) remitted completely or was alleviated during school holidays, d) its remission was usually spontaneous during the day and e) did never interfere with recreational activities. Emotional problems were significantly more prevalent in patients in group B than in those in group A (p = 0.016). Past diagnosis of depression was more frequent in group A mothers (40%) than in those in group B (27%), or group C (17%), but these differences did not attain statistical significance. These results suggest that psychological profiles of children suffering from certain chronic conditions (and those of their parents) may be more complex and particular than hitherto recognized. The role of type II error and of some potential socioeconomic and demographic confounding factors must be considered when analyzing the validity of these data.
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PMID:[Clinical and psychological characterization of children and adolescents with recurrent abdominal pain]. 873 76

Cryptosporidial oocyst infection is a common cause of diarrhea in patients with AIDS. Concomitant symptoms can include crampy abdominal pain, nausea, vomiting, and anorexia. Esophagogastroduodenoscopy is then useful for delineating potentially treatable pathogens. We report a case of cryptosporidial duodenitis with characteristic endoscopic findings, biopsy correlate, and a review of the current literature. The endoscopic appearance illustrated strongly suggests proximal small bowel mucosal involvement with cryptosporidial oocysts.
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PMID:Endoscopic appearance of cryptosporidial duodenitis. 885 57

The yield of upper gastrointestinal endoscopy (esophago-gastroduodenoscopy; EGD) in human immunodeficiency virus (HIV)-infected patients based on presenting symptoms has not been well studied. We studied consecutive patients with documented HIV infection undergoing EGD at a large innercity hospital between August 1, 1990 and December 31, 1993; all had presenting symptoms and indications for EGD prospectively recorded at the time of EGD. All endoscopic abnormalities were routinely subjected to biopsy, and extensive histopathological evaluation was performed. EGD was considered helpful when the findings stimulated specific therapeutic intervention other than antifungal or antacid medications. The specific indications for EGD in 156 patients were as follows: esophageal symptoms, 102 patients (65%); abdominal pain, 18 (12%); upper gastrointestinal bleeding, 25 (16%); refractory nausea and vomiting, 11 (7%). Overall, pathologic findings were identified in 116 patients (74%): in refractory esophageal symptoms, 82%; upper gastrointestinal bleeding, 92%; abdominal pain, 39%; nausea and vomiting, 27%. EGD with biopsy identified a specifically treatable opportunistic disorder other than Candida in 80 patients (51%), including idiopathic esophageal ulcer (22%) or viral esophagitis and/or duodenitis (29%). EGD was not helpful in 22.3% of cases, those involving Candida (12.3%) and peptic ulcer disease (PUD)-related causes (10%). The mean CD4 count of patients with opportunistic pathologic findings (24/mm3, n = 79) was significantly lower than that of patients with PUD/gastroesophageal reflux disease (GERD) (167/mm3, n = 9) or negative EGDs (165/mm3, n = 35). Overall, the results of EGD influenced patient management in 78% of cases. We conclude that selective symptom-specific use of EGD, particularly in patients with esophageal symptoms refractory to antifungal therapy or gastrointestinal bleeding, usually identifies specifically treatable abnormalities, whereas EGD is less useful for the evaluation of abdominal pain or nausea and vomiting.
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PMID:Symptom-specific use of upper gastrointestinal endoscopy in human immunodeficiency virus-infected patients yields high dividends. 895 33

A retrospective study of 200 endoscopies performed on 168 children (90 girls and 78 boys) aged 3 months to 18 years (median 6 years) is reported. All procedures were completed successfully in an adult endoscopy unit in a comprehensive health centre. Most children of less than 6 months and above 12 years of age needed no intravenous sedation. One child developed respiratory depression and was successfully resuscitated. Indications for endoscopy were: small intestinal biopsy, 78 (46%); recurrent abdominal pain, 40 (24%); acute epigastric pain, 13 (8%); persistent vomiting, 12 (7%); haemorrhage, 10 (6%); caustic substance ingestion, six (4%); and dysphagia, four (2%) children. Positive diagnoses were obtained in 123 (62%) procedures. Coeliac disease (26 cases) was the most common histological diagnosis, followed by gastritis (19 cases), oesophagitis (18 cases), duodenitis (16 cases), duodenal ulcer (11 cases), hiatus hernia (six cases), gastric ulcer (three cases) and oesophageal stricture (two cases). Where specialized paediatric endoscopy units are not feasible, e.g. in developing countries, endoscopic services for children can be safely provided by paediatric endoscopists as part of an adult endoscopy service, provided that suitable resuscitation equipment is available and the necessary modifications to meet the medical and psychological needs of children and their parents are taken into consideration.
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PMID:Paediatric upper gastro-intestinal endoscopy in developing countries. 898 32

To investigate the prevalence and the significance of Helicobacter pylori duodenal colonization, endoscopic duodenal biopsies were performed in 168 children with chronic abdominal pain, gastroesophageal reflux, gastrointestinal bleeding, and malabsorption syndrome. Helicobacter pylori infection was detected in 68 children (40.4%): in 31 of them H. pylori was present in the gastric antrum, and in 37 in the duodenum also. Duodenitis was observed in 25 children with duodenal H. pylori; gastric metaplasia in 3. Scanning electron microscopy revealed the presence of the micro-organism in 3/13 cases; the bacteria were located in the intercellular spaces and alterations of the epithelial surface were found. In conclusion, H. pylori gastritis in children is often associated with duodenal colonization which can cause duodenitis, and also without gastric metaplasia, which indicates a possible role of the micro-organism in the pathogenesis of the lesions.
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PMID:Helicobacter pylori duodenal colonization in children. 917 19


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