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

The case of a 24-year-old man who accidentally ingested liquid zinc chloride is presented. Local caustic effects included erosive pharyngitis and esophagitis. Nausea, vomiting and abdominal pain, as well as hypocalcemia and hyperamylasemia, suggested acute pancreatitis. Microhematuria occurred, but renal function did not deteriorate. Lethargy and confusion, noted previously in another case of hyperzincemia, were present. Chelation therapy was instituted, with reversal of the clinical and biochemical effects of zinc poisoning.
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PMID:Accidental ingestion of liquid zinc chloride: local and systemic effects. 678 11

Patients with cholelithiasis and history of atypical abdominal pain present the surgeon with a challenging clinical problem. We hypothesized that preoperative esophagogastroduodenoscopy before cholecystectomy would identify patients with concomitant upper gastrointestinal pathology. Retrospective review of 143 patients who presented with atypical abdominal pain, gallstones, and underwent EGD before their cholecystectomy between July 1989 and March 1994. A total of 1162 cholecystectomies were performed during the study period; 143 patients (12 per cent) underwent a preoperative EGD because of atypical abdominal pain. One hundred ten patients (77 per cent) had normal endoscopies. Thirty-three patients (23 per cent) had abnormal findings. Gastric polyps were found in three patients and esophageal varices in one patient. There were 36 findings in 29 patients, which included peptic ulcer disease, esophagitis, gastritis, and duodenitis. Seven patients had two abnormal findings. Moderate to severe disease was found in a total of 13 (9 per cent) patients. We recommend that patients who present with cholelithiasis and atypical abdominal pain undergo preoperative esophagogastroduodenoscopy, as we have found that at least 9 per cent of the patient population will have significant findings that may alter their management.
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PMID:Precholecystectomy esophagogastroduodenoscopy: is it of value? 748 38

Infections of the esophagus are unusual in the general population and strongly imply immunodeficiency, although immunocompetent individuals are not exempt. HIV infection is predominant among risk factors for infectious esophagitis. For all immunocompromised patients, the most frequently identified esophageal pathogens are Candida, CMV, and HSV. Peculiar to HIV-infected patients are idiopathic esophageal ulcers as well as unusual bacteria and parasites. Patterns of presentation differ with each infecting organism, and clinical features should be used as a guide in achieving a correct diagnosis. For example, a patient with AIDS presenting with esophageal symptoms and thrush, along with abdominal pain, nausea, vomiting, and fever, is unlikely to resolve all symptoms with empiric antifungal therapy alone. Parsimony of diagnosis does not hold among immunodeficient patients in whom concurrent infections are common. Accurate and timely diagnoses are essential as effective treatments are available for particular etiologies. Finally, among immunocompromised patients, all esophageal symptoms are not necessarily due to an infection, and possible diagnoses of pill esophagitis, acid-peptic injury, or structural and functional abnormalities should not be overlooked.
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PMID:Esophageal infections: risk factors, presentation, diagnosis, and treatment. 752 21

Helicobacter pylori (HP) is a newly discovered pathogen implicated in the pathophysiology of peptic ulcer disease. The aim of this study was to review all pediatric patients who were evaluated by upper endoscopy through the Pediatric Gastroenterology Service at the Marshall University School of Medicine between July 1990 and March 1993. A total of 100 charts were retrospectively reviewed. HP was diagnosed by CLO-test and confirmed histologically. Results showed that the major presenting symptom was abdominal pain (53%). GI mucosal inflammation was found in 77 patients, and 41% of these cases were associated with HP. Two patients had duodenal ulcer; both were HP+. The incidence of gastritis was significantly higher in patients with HP+ compared to HP-. Follow-up on the HP-associated gastritis showed no significant difference in their clinical response irrespective to the treatment, we conclude that HP in children is highly associated with gastritis, but not duodenitis or esophagitis; and in our experience, that CLO has a high failure rate in identifying HP in the mucosa.
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PMID:A study of Helicobacter-pylori in 100 pediatric patients from the Tri-State area. 799 84

Many patients with acid-peptic disease have idiopathic gastric acid hypersecretion defined as a basal acid output > 10.0 meq/hr; however, a significant proportion have basal acid outputs > 15.0 meq/hr, which is within the range found in Zollinger-Ellison syndrome. Although idiopathic gastric acid hypersecretion is more common than Zollinger-Ellison syndrome, it is important that these two disorders be differentiated because of differences in treatment and natural history. In the present study, we compared 124 patients with idiopathic gastric acid hypersecretion and 137 patients with Zollinger-Ellison syndrome. There were no significant differences with regard to age at diagnosis, history of upper gastrointestinal hemorrhage, nausea, vomiting, and family history of duodenal ulcer and other acid-peptic disease. However, significant differences were observed between patients with idiopathic gastric acid hypersecretion and patients with Zollinger-Ellison syndrome with regard to percentage of males: 77% compared to 64% (P = 0.008), mean serum gastrin: 60 pg/ml compared to 3679 pg/ml (normal < 100 pg/ml) (P < 0.001), mean basal acid output: 15.4 meq/hr compared to 47.0 meq/hr (P < 0.001), mean age at onset of symptoms: 33 years compared to 41 years (P < 0.001), mean duration of symptoms before diagnosis: 11 years compared to five years (P < 0.001), percentage with abdominal pain: 67% compared to 82% (P = 0.00004), percentage with diarrhea: 12% compared to 75% (P < 0.000001), percentage with pyrosis: 58% compared to 40% (P = 0.003), percentage with duodenal ulcer: 53% compared to 74% (P < 0.000001), and percentage with esophagitis: 31% compared to 42% (P = 0.0004).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Idiopathic gastric acid hypersecretion. Comparison with Zollinger-Ellison syndrome. 802 53

During a 4 year period (January 1988 to December 1991), 237 pediatric patients (mean age +/- SD, 9.75 +/- 5.17 years) underwent 289 upper gastrointestinal endoscopies. Premedication was used in only 102 of the endoscopic examinations, mostly in children between 2 and 10 years of age. Patients who were examined without sedation tolerated the procedure well. Abdominal pain was the most frequent indication, accounting for 57.4% of all procedures. Gastritis, esophagitis, duodenitis and duodenal ulcer were the most common endoscopic findings. Seventy-five endoscopies were performed to obtain small bowel biopsies. We found this procedure to be easy and safe and preferable to capsule biopsies. In our experience, upper gastrointestinal endoscopy with or without sedation is a safe and effective diagnostic procedure in the pediatric age group.
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PMID:Upper gastrointestinal endoscopy in the pediatric patient. 804 55

There are increasing challenges for the practising gastroenterologist in treating AIDS-related gastrointestinal diseases. The differential diagnoses of dysphagia and odynophagia include cytomegalovirus (CMV) and herpes simplex virus (HSV) infection, non-specific aphthous ulceration and non-AIDS oesophageal diseases, especially reflux oesophagitis. Chronic subacute abdominal pain with nausea, vomiting, early satiety and weight loss is suggestive of an obstructive lesion caused by lymphoma or Kaposi's sarcoma. Severe acute abdominal pain can indicate pancreatitis or intestinal perforation due to cytomegalovirus. Right upper quadrant pain (with or without fever, vomiting or abnormal liver function tests with a cholestatic profile) is suggestive of hepatobiliary pathology including cholecystitis, cholangitis, acalculous cholecystitis and AIDS cholangiopathy. Diarrhoea is the most common gastrointestinal symptom of AIDS, affecting 50-90% of patients. Causes of AIDS diarrhoea include protozoa (Cryptosporidium parvum, Isospora belli, Enterocytozoon bieneusi, Septata intestinalis, Cyclospora spp, Entamoeba histolytica and Giardia lamblia), bacteria (Mycobacterium avium-intracellulare, Clostridium difficile, Salmonella, Shigella and Campylobacter jejuni), and viruses (CMV, HSV and possibly HIV). Chronic diarrhoea, malnutrition and weight loss can shorten the life-span of patients with AIDS. Elemental diets, isotonic formulas, medium chain triglycerides and total parenteral nutrition have been tried with little success in AIDS patients with severe diarrhoea and wasting.
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PMID:AIDS and the gut. 805 32

Helicobacter pylori is an important factor in the pathogenesis of chronic gastritis and gastroduodenal ulcer disease. However, the basic causal mechanisms of H pylori colonization on the gastric mucosa are still unclear. The authors evaluated the prevalence of H pylori colonization in 266 children who underwent upper gastrointestinal endoscopy during a 12-month period. The indications for endoscopy were follow-up of esophagitis related to gastroesophageal reflux (n = 17), suspicion of gastroesophageal reflux (n = 51), abdominal pain (n = 28), vomiting (n = 30), follow-up of esophageal atresia (n = 46) and duodenal atresia (n = 28), inflammatory bowel disease (n = 28), and miscellaneous (n = 38). The methods used to detect H pylori colonization were histology and the rapid urease test. H pylori colonization was demonstrated in 31 (11.6%) of the 266 patients. In two patient groups, a high prevalence of colonization was identified. In patients with an operated duodenal atresia, 36% (10 of 28) had H pylori on the gastric mucosa. The organism was demonstrated on the gastric mucosa in 47% (8 of 17) of the patients with gastroesophageal reflux-related esophagitis; five of the eight patients had neurological impairment. In the other patient groups, the prevalence of H pylori infection ranged from 2% to 14%. The present study suggests that, in children, the disturbed esophagogastroduodenal motility, which is commonly associated with gastroesophageal reflux and duodenal atresia, predisposes to H pylori infection.
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PMID:Does disordered upper gastrointestinal motility predispose to Helicobacter pylori colonization of the stomach in children? 807 8

Authors studied the occurrence and clinical outcome of hiatal hernia in 18 patients during a 7-year period. The age of the children from 10 years to 15 years, with a mean age of 12.8 years. Their patients had recurrent abdominal pain, 4 of them had chest pain. 13 patients had macroscopic oesophagitis. Under medically treatment 16 patients has been well. Two cases required surgery. Aetiology of hiatal hernia in children is unknown.
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PMID:[Hiatal hernia in childhood]. 812 86

Discussion of pain problems in persons with AIDS has been limited in medical and nursing literature, yet pain is a major source of suffering and concern for patients. Common pain characteristics are described in 100 persons with CDC-defined AIDS, using the 1987 definition. The two most frequently cited types of pain for both drugs users and nondrug users with AIDS were abdominal pain and neuropathic pain. Drug users experienced pain due to esophagitis and headaches more frequently than nondrug users, while nondrug users experienced Kaposi's sarcoma-related pain more often. Treatment responses were individualized, with drug users requiring more frequent use of opiates. General treatment strategies are suggested with special emphasis on the unique needs of PWAs.
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PMID:Pain characteristics and their management in persons with AIDS. 813 Mar 70


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