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

Two cases of the Churg-Strauss syndrome are reported, seen within the past year. The first concerned a 31-year-old woman with a rapidly progressive illness characterized by bronchial asthma, leukocytosis and eosinophilia, abdominal pain, diarrhoea and purpura. In the second case, a 47-year-old man had granulomatous epididymitis and interstitial nephritis before the asthma and eosinophilia developed. In both the diagnosis was confirmed by lung biopsy. Immunosuppressive treatment achieved rapid regression of all symptoms and of the eosinophilia, without recurrence so far.
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PMID:[Systemic necrotizing vasculitis with bronchial asthma and eosinophilia: Churg-Strauss syndrome]. 289 61

Testicular torsion is characterized by the sudden onset of testicular pain associated with abdominal pain, nausea and vomiting. Fever is unusual and urinalysis is often normal. Fever, pyuria, dysuria and urethral discharge are characteristic of epididymitis. Radionuclide scanning and Doppler ultrasound are helpful in establishing the diagnosis. If the diagnosis is uncertain, the patient should be considered to have testicular torsion until it is proved otherwise. Undiagnosed torsion leads to testicular necrosis.
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PMID:The acute scrotum. 327 40

The differential diagnosis in acute scrotum, particularly torsion of spermatic cord and epididymitis, is sometimes difficult. An erroneous diagnosis may result in unnecessary and improper treatment. We report two cases of testicular infarction including torsion of spermatic cord, preoperatively diagnosed by enhanced magnetic resonance imaging (MRI). Case 1: A 16-year-old boy presented with a 3-day history of left scrotal swelling and left lower abdominal pain. He had fever and leukocytosis. Antibiotics for 2 days failed to relieve the symptoms. Enhanced MRI showed absence of blood flow in the left testis. Scrotal exploration revealed hemorrhage and necrosis in the left testis. Left orchiectomy and right orchiopexy were performed. Case 2: A 12-year-old boy visited with scrotal swelling and fever 30 hours after an acute onset of left scrotal pain. Enhanced MRI showed absence of blood flow in the left testis. Exploration revealed left necrotic testis with torsion of spermatic cord. Left orchiectomy and right orchiopexy were performed. Our two cases suggested that enhanced MRI, by which the intratesticular blood flow can be evaluated, may be useful for the diagnosis of testicular infarction.
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PMID:[Two cases of testicular infarction: the usefulness of enhanced MRI for preoperative diagnosis]. 1033 Nov 76

We report two cases of torsion of the spermatic cord in undescended testis. Case 1: A 23-year-old man was admitted to our hospital with the complaints of fever and left inguinal pain. He had cerebral palsy in his past history. Tentative diagnosis of acute epididymitis of left undescended testis was made, and antibacterial drugs were given. Response was poor, and torsion of the spermatic cord was suspected strongly. Torsion of the spermatic cord in undescended testis and severe testicular infarction were seen in surgery after 13-day conservative treatment. Orchiectomy was performed. Case 2: A 6-year-old boy was admitted to our hospital with the chief complaints of left inguinal mass and pain. He had felt abdominal pain for 3 days. Scrotal contents were impalpable and the diagnosis of torsion of the spermatic cord was made. Orchiectomy was performed due to severe testicular infarction.
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PMID:[Torsion of the spermatic cord in undescended testis: report of two cases]. 1101 77

The differential diagnosis of left lower quadrant abdominal pain in an adult man includes, among others, sigmoid diverticulitis; leaking abdominal aortic aneurysm; renal colic; epididymitis; incarcerated hernia; bowel obstruction; regional enteritis; psoas abscess; and in this rare instance, situs inversus with acute appendicitis. We report a case of situs inversus totalis with left-sided appendicitis and a brief review of the literature. There were several subtle indicators of total situs inversus present that were missed by the physicians and surgeons who initially evaluated the patient prior to surgery. Computed tomography scan with contrast, however, revealed the diagnosis immediately, and treatment was successfully initiated.
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PMID:Left lower quadrant pain of unusual cause. 1126 11

We describe an unusual case of metastatic choriocarcinoma of the pancreas arising from a regressing testicular mixed germ cell tumor that clinically mimicked a primary pancreatic tumor. A 54-year-old male presented with a 2-month history of progressive upper abdominal pain, weight loss, and jaundice. He also had a history of recurrent epididymitis associated with the presence of a right testicular mass shown to be cystic by ultrasound and stable for at least 10 years. A computed tomography scan showed an isolated 6 cm mass in the head of the pancreas. A pancreaticoduodenectomy was performed. Upon histological examination, the pancreatic tumor showed extensive hemorrhage and necrosis. In the viable area, the tumor was composed of an intimate mixture of mononuclear cytotrophoblast cells and multinucleated syncytiotrophoblasts with vascular invasion. These characteristic features led to the correct diagnosis on frozen section. The cytology of the tumor was nonspecific and suggested undifferentiated carcinoma of the pancreas. The trophoblastic origin of the tumor cells was confirmed by immunohistochemistry staining. The testicular mass showed a regressed mixed germ cell tumor of predominantly seminoma with focal teratoma but without a choriocarcinoma component. In conclusion, we present a rare and unusual case of a regressing testicular mixed germ cell tumor that presented as a primary pancreatic tumor. Cytological features of the pancreatic mass were not specific and raised the possibility of a primary undifferentiated carcinoma of the pancreas. Characteristic histological features of choriocarcinoma led to the correct diagnosis on frozen section. Subsequent resection of the testicular mass confirmed the presence of a cystic and scarring (regressing) mixed germ cell tumor but without evidence of choriocarcinoma.
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PMID:Choriocarcinoma involving the pancreas as first manifestation of a metastatic regressing mixed testicular germ cell tumor. 1554 58

Genital infections with Chlamydia trachomatis occur in all social groups in Germany. About 100,000 German women are sterile because of tubal scarring due to chlamydiae. Genital chlamydial infections are asymptomatic in 70% of patients, even if salpingitis occurs. Typical symptoms of chlamydial infection are purulent cervicitis with vaginal discharge, painful cervical bleeding because of endometritis, lower abdominal pain with dyspareunia, and upper abdominal pain because of perihepatitis. DNA amplification tests on first voided urine or cervical swab are the most sensitive routine tests. Specific serum antibodies to C. trachomatis indicate a previous infection in sterile women. For treatment, a 10-14 day course of doxycycline 200 mg daily or a macrolide antibiotic in the patient as well as in the sexual partner is recommended. In the male, C. trachomatis causes urethritis and epididymitis. Opinions differ about involvement of the prostate gland and seminal vesicles. Identification of C. trachomatis antigen or DNA in the accessory gland secretions is not sufficiently reproducible. The two vectors are easily diagnosed in urethral swabs or in urine. The occurrence of chlamydial antibodies in serum or in seminal fluid is not a sign of current infection. Reliable studies which indicate a reduced fertility of men infected with C. trachomatis are not available.
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PMID:[Urogenital chlamydial infections in women and men]. 1721 68

A 67-year-old man presented with isolated pain of the right testicle. He was admitted and treated for epididymitis. His symptoms did not improve and lower abdominal pain developed. After hypotension and severe anaemia (Hb 2.1 mmol/l) had developed, abdominal echography was carried out, revealing a ruptured abdominal aortic aneurysm. The patient underwent surgical repair with an aortic-bifemoral prosthesis and was ultimately discharged without further complications. This is the fourth report in the literature of orchidodynia as referred pain from an aneurysm of the abdominal aorta.
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PMID:[Isolated orchidodynia as the initial symptom of aneurysm of the abdominal aorta]. 1755 24

Between July 1986 and March 2006, 102 patients underwent an operation for acute scrotum. Median age was 12.0 years old (range 0-51). Post-operative diagnosis revealed 50 cases (49%) of spermatic cord torsion, 29 cases (28%) of epididymal appendix torsion, and 13 cases (13%) of acute epididymitis. Spermatic cord torsion was most frequent in the age between 0 and 5, and 11 and 20, while epididymal appendix torsion was most frequent between 6 and 10. Moreover, acute epididymitis was most frequently seen in the age over 20. There were no apparent differences in the clinical symptoms such as scrotal pain, scrotal swelling, and abdominal pain. In the physical examinations, pyuria was the only finding to indicate acute epididymitis. In case of spermatic cord torsion, 'golden time' is defined as the time from onset to operation when testicular function can be expected for preservation. In this study golden time was defined as 8 hours because the testes was preserved in all 23 patients receiving the operation within 8 hours, but in only 10 (37%) out of 27 patients receiving the operation after 8 hours. Moreover, the operation within 24 hours saved the testes in approximately 90% of the patients. In patients with acute scrotum, emergency operation should be performed as speedily as possible for preservation of testicular function.
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PMID:[Clinical study on operative treatment of acute scrotum]. 1762 35

Scrotal masses can represent a wide range of medical issues, from benign congenital conditions to life-threatening malignancies and acute surgical emergencies. Having a clear understanding of scrotal anatomy allows the examiner to accurately identify most lesions. Benign lesions such as hydroceles and varicoceles are often found incidentally by the patient or physician on routine examination. Epididymitis is bacterial in origin, readily diagnosed on physical examination, and treated with antibiotics. Indirect inguinal hernias usually are palpable separate from the normal scrotal contents and are a surgical emergency if strangulation is suspected based on symptoms of abdominal pain, tenderness, and nonreducibility. Testicular swelling may be caused by orchitis, cancer, or testicular torsion. Orchitis is usually viral in origin, subacute in onset, and may be accompanied by systemic illness. Testicular carcinomas are more gradual in onset; the testis will be nontender on examination. Testicular torsion has an acute onset, often with no antecedent trauma; the involved testis may be retracted and palpably rotated, and will be tender on examination. The swollen testis is always a true emergency. Although history and examination may suggest the diagnosis, testicular torsion can be reliably confirmed only with color Doppler ultrasonography, which must be obtained immediately. If torsion is suspected, surgical consultation should be obtained concurrently with ultrasonography, because the ability to successfully salvage the affected testis declines dramatically after six hours of torsion.
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PMID:Evaluation of scrotal masses. 1903 65


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