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

We present a case of a 53-year-old man with complaints of severe abdominal pain and nausea. Emergency department abdominal workup was non-diagnostic. Physical examination revealed signs of right- and left-heart failure. A past medical history of dysrhythmias and chronic abdominal complaints prompted hospital admission. Subsequent right heart catheterization revealed a significant left-to-right shunt. CT scan of the chest and angiography confirmed the diagnosis of an abnormal ascending vein between the innominate vein and the left superior pulmonary vein. After the anomalous vein was ligated, the patient's abdominal pain resolved.
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PMID:Congenital heart disease manifested as acute abdominal pain. 1743 25

Spontaneous aortocaval fistula is a rare complication of abdominal aortic aneurysm rupture. A definitive preoperative diagnosis sometimes is difficult, because ofnonspecific and highly variable clinical symptoms. Classic signs such as low back pain, palpable pulsatile abdominal mass, abdominal bruit and thrill, dyspnea and high-output cardiac failure are present in less than 50% of cases. In this article we report the case of a 68-year-old patient with an aortocaval fistula who was admitted in hospital because of abdominal pain and hematuria.
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PMID:[Spontaneous aortocaval fistula]. 1755 49

Pregnancy is contraindicated in cases of maternal pulmonary hypertension, a highly morbid disease affecting young women of childbearing age. The rate of heart failure increases gradually with the severity of pulmonary hypertension. In certain instances, the severity of maternal pulmonary hypertension in rheumatic heart diseases can be higher than in congenital heart diseases. Placenta accreta is an important cause of bleeding in the second half of pregnancy and in labor. In severe cases, hysterectomy is the only way to manage the bleeding during cesarean section. A 33-year-old gravida, G2P0AA1, suffering from rheumatic heart disease with mitral valve stenosis and pulmonary hypertension, was referred to our high-risk pregnancy center at 10(+3) weeks of gestation due to lower abdominal pain and brownish vaginal bleeding. She had received 2 mitral valve replacements in Shenzhen, China, at the ages of 22 and 26, respectively. Ultrasound scan of the abdomen at 12(+2) gestational weeks showed that the internal cervix was completely covered with the placenta, and a retroplacental hypoechoic space measuring 35 x 13 mm was observed at the upper posterior margin of the placenta. On color Doppler scan, an area of lacunar lake flow was observed in the hypoechoic space of the placenta and a spiral artery with low blood flow resistance was detected. The pulsation of the placental flow was synchronized with the maternal pulse rate. Team specialists, including neonatologists, pulmonary physicians, pediatric cardiologists, hematologists, anesthesiologists, psychiatrists and social workers, as well as high-risk obstetricians were consulted in an effort to minimize fetal and maternal morbidity and mortality. At 29(+2) weeks, the patient developed preeclampsia and delivered a healthy newborn by cesarean section, the uterus being preserved by square compression sutures. The gravida tolerated the procedures and was discharged in stable condition.
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PMID:Pregnancy complicated with maternal pulmonary hypertension and placenta accreta. 1759 87

An aorto-caval fistula caused by a ruptured false aneurysm of the abdominal aorta was reported. A 70-year-old male who had a history of aorto-femoral bypass was admitted because of right lower abdominal pain. Enhanced computed tomography scans revealed aorto-caval fistula. The patient exhibited high output heart failure and acute renal failure. Stent-grafting for abdominal aorta was performed. Intra- and postoperative examination revealed no leakage from the aorta to the vena cava. Endoluminal treatment for aorto-caval fistula is efficacious as less invasive treatment.
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PMID:Management of an aorto-caval fistula from a ruptured aortic false aneurysm using a covered stent graft. 1767 Jul 36

In single cases mitochondrial disorders may manifest as pancreatitis, but recurrent, chronic pancreatitis with exacerbations of at least 15 times without morphological alterations of the pancreas but concomitant diabetes mellitus has not been reported. In a 57-year-old Caucasian male mitochondrial disorder was diagnosed at the age of 49 years upon epilepsy with generalized and focal seizures, cognitive decline, migraine, mitochondrial myopathy, polyneuropathy, diabetes mellitus, hypokalie-mia, hyperlipidemia, atrial fibrillation, heart failure, sicca syndrome, recurrent pancreatitis, chronic diarrhea, polydipsia, hyperhidrosis, steatosis hepatis, anemia, thrombopenia, an abnormal lactate stress test, and a muscle biopsy showing ragged-red muscle fibers, single completely COX-negative fibers, target fibers, increased number of sarcoplasmatic lipid droplets, but normal mitochondrial morphology on electron microscopy. Between the age of 33 years and the age of 44 years, at least 15 episodes of pancreatitis, manifesting as severe abdominal pain, and elevated exocrine pancreatic enzymes, but without morphological alterations of the pancreas, responding well to H2-blockers and food restriction had occurred. Recurrent pancreatitis without morphological alterations of the pancreas may be a feature of multisystem mitochondrial disorder resulting in diabetes mellitus. Physicians should familiarize with pancreatitis as a manifestation of a mitochondrial disorder and mitochondrial disorder should be excluded in patients with pancreatitis.
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PMID:Recurrent pancreatitis as a manifestation of multisystem mitochondrial disorder. 1791 91

Peripartum cardiomyopathy (PPCM) is a rare form of heart failure with a reported incidence of 1 per 3000 to 1 per 4000 live births and a fatality rate of 20%-50%. Onset is usually between the last month of pregnancy and up to 5 months postpartum in previously healthy women. Although viral, autoimmune and idiopathic factors may be contributory, its etiology remains unknown. PPCM initially presents with signs and symptoms of congestive heart failure and rarely with thrombo-embolic complications. We report an unusual case of PPCM in a previously healthy postpartum woman who presented with an acute abdomen due to unrecognized thromboemboli of the abdominal organs. This case illustrates that abdominal pain in PPCM may not always result from hepatic congestion as previously reported, but may occur as a result of thromboemboli to abdominal organs. Further research is needed to determine the true incidence of thromboemboli in PPCM.
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PMID:An unusual case of peripartum cardiomyopathy manifesting with multiple thrombo-embolic phenomena. 1796 97

Splenic arteriovenous fistula is a rare complication following splenectomy. We report a case of a large splenic arteriovenous fistula 23 years after splenectomy in a 50-year old male with abdominal pain, gastro-intestinal bleeding, ascites, diarrhoea, dyspnoea, portal hypertension and heart failure. The arteriovenous fistula was successfully treated with percutaneous transarterial embolization and the patient gained almost complete recovery. This case demonstrates the usefulness of embolization of an otherwise surgical demanding arteriovenous fistula.
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PMID:Splenic arteriovenous fistula treated with percutaneous transarterial embolization. 1877 14

Hemangioma is the most frequent focal liver lesion. It affects mainly women and may cause symptoms such as abdominal pain, mass, and early satiety, or complications such as heart failure or coagulopathy (Kasabach-Merrit syndrome). Although, surgical resection is the only curative treatment for symptomatic giant hemangiomas, the best surgical technique (formal liver resection or enucleation) is still debated. Between January 2000 and April 2006 we treated 12 giant symptomatic hemangioma. Of these, 4 anterior and superficially located in the liver were treated by enucleation and they are discussed in this paper. The operative technique is described. Detailed pathologic examination has demonstrated an interface between hemangiomas and the normal liver tissue that allowed the enucleation. The dissection in the plane between the tumor and the adjacent normal liver tissue has been facilitated by the use of an ultrasonically activated device (USAD). Median operative blood loss was 90 ml (range, 50 to 190 ml), and no transfusion were used. The procedure described allowed a safe enucleation of giant hemangiomas with a reduced blood loss and the preservation of virtually all normal hepatic parenchyma.
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PMID:Surgical treatment of giant liver hemangiomas by enucleation using an ultrasonically activated device (USAD). 1945 65

A 60-year-old woman with hepatic encephalopathy was admitted to our hospital. Ultrasonography, computed tomography and hepatic arteriography revealed diffuse hepatic arteriovenous fistulae (HAVF). Overt portosystemic shunt could not be identified. Right heart catheterization showed increased cardiac output. However the patient had never shown any signs of heart failure. Other than that, marked hepatopetal arterial flow from some branches of the superior mesenteric artery was detected and mesenteric arterial flow remarkably decreased. Extensive HAVF can lead to significant complications, including high output heart failure, pulmonary hypertension, portal hypertension, hepatic encephalopathy, biliary ischemia, cirrhosis, postprandial abdominal pain, and reduced liver function. Embolization or ligation of the hepatic artery provides temporal improvement of clinical symptoms, but long-term results are unsatisfactory because of the development of collateral circulation and the risk of refractory intrahepatic cholangitis, subsequently leading to liver failure. Liver transplantation offers another therapeutic option and can be a successful curative treatment.
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PMID:[A case of diffuse hepatic arteriovenous fistulae with hepatic encephalopathy, postprandial abdominal pain and biliary injury]. 1957 12

Portal arteriovenous fistulas are uncommon and are most often seen following trauma to the abdomen. In a few cases they have occurred as complications of abdominal surgery. In this report we present a 74 year old man with a fistula between the left gastric artery and vein, secondary to a Billroth I partial gastrectomy that was performed 32 years earlier. The patient complained of a diffuse abdominal pain for two weeks and mild cardiac failure symptoms. An epigastric bruit was heard and the abdomen was distended with transudatic ascitic fluid. The fistula was diagnosed by Doppler-ultrasound and the diagnosis confirmed by angiography. At laparotomy the fistula was excised and the patient's symptoms subsequently subsided.
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PMID:[Arteriovenous fistula after partial gastrectomy. A case report.]. 1967 2


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