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

The results of the radiological examination of 330 children following oral administration of barium are reported. It is pointed out that if one just takes into account the undoubted organic diseases, only a few children would benefit from the examination; in our case only 9 of them (a gastric and a duodenal ulcer, a pancreas pseudocyst, 5 hiatal hernias, and a celiac disease), i.e. 3%. This is not very satisfactory from a practical point of view. This situation improves radically when one looks for diseases usually rated as questionable: small hiatal hernia (cardiotuberositary malposition), functional disturbances of the small intestine, reactive hyperplasia of the lymphoid tissue, and chronic appendicitis. Thus we were able to offer 177 children, i.e. 53% of them, an efficacious therapy. The importance of chronic appendicitis and of functional disturbances of the small intestine as a cause of abdominal pain in children is pointed out, and their radiological symptoms are discussed. Finally the not uncommon, but not very well known disease of incomplete sigmoid volvulus is described.
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PMID:[Radiologic findings in abdominal pain in children (author's transl)]. 42 1

The purpose of this paper is to study the use of upper gastrointestinal (Gl) fiberoptic endoscopy in children. Two hundred consecutive patients referred to one of the authors were reviewed. The indications for performing upper gastrointestinal endoscopy in these 200 patients were: (1) recurrent abdominal pain (46.5%), (2) persistent vomiting (14.5%), (3) haematemesis (14.5%), (4) acute abdominal pain (13%) and (5) other indications such as foreign body removal, failure to thrive and unexplained chest pain (11.5%). The endoscopy was performed with the Olympus P3 or Olympus XP-10 gastroscopes. The sedation used was a combination of intravenous pethidine (2mg/kg) and diazepam (0.5 mg/kg). Among the patients with recurrent abdominal pain, upper Gl endoscopy showed duodenal ulcer in 7 patients (7.5%), duodenitis in 4 (4.3%), oesophagitis in 4 (4.3%) and gastric ulcer in 2 (2.2%). The rest of the patients were normal (81.7%). With regard to persistent vomiting, 37.9% of the patients showed gastroesophageal reflux and 6.9% had a hiatus hernia. Of 29 patients examined endoscopically for upper Gl bleeding, no focus of bleeding was identified in 27.6%. The remaining 72.4% were bleeding from acute gastric erosion (27.6%), oesophagitis (17.2%), oesophageal varices (13.8%), duodenal ulcer (10.3%) and Mallory-Weiss tear (3.5%). The Majority of the patients with acute abdominal pain were normal endoscopically (61.5%). The two common abnormal findings were acute gastritis (27.0%) and acute duodenitis (11.5%). No major complications were encountered during the procedure in these 200 patients. It was concluded that upper Gl endoscopy is useful for defining upper Gl mucosal pathology. The procedure can be performed safely in children under sedation.
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PMID:Upper gastrointestinal endoscopy in children. 237 74

Twenty two patients (age range: 1 month to 11 years) were treated for congenital diaphragmatic defects (excluding hiatus hernia) in the six year period 1983-8. Presenting features were failure to thrive (n = 7), abdominal pain and vomiting (n = 4), chronic respiratory symptoms (n = 3), and inability to wean from ventilatory support (n = 3). The defect was an incidental finding in five patients. Operative repair was performed with no mortality or serious postoperative morbidity. Dramatic improvement occurred in 15 of the 17 symptomatic patients. Awareness of the differential diagnosis should avoid delay in diagnosis or inappropriate treatment. Surgical correction is strongly recommended in all cases.
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PMID:Congenital diaphragmatic defects that present late. 260 12

The characteristics and the prevalence of functional bowel disorders in the general French population are unknown. Based on an epidemiological inquiry in a random population of 1,200 persons who were not seeking care, residents in our country we established: the prevalence of symptoms suggestive of functional bowel disorders; the epidemiological differences between symptomatic subgroups which included abdominal pain with or without bowel dysfunction, diarrhea and constipation. The amount of cases and the prevalence in each subgroup were: abdominal pain, 165, 13.8 p. 100, painless constipation, 75, 6.3 p. 100, diarrhea, 10, 0.8 p. 100. As a whole, functional bowel disorders occurred in 20 p. 100 of our population. The "irritable bowel syndrome" group defined as abdominal pain and/or diarrhea differ from normal subjects by the following higher frequency of age under 50, subjects in active duty, antecedents of diverticulosis, influence of stress on symptoms, nausea, vomiting, migraines, pyrosis and number of visits to a doctor. However neither the sex-ratio nor professional occupation were relevant. The constipation group differed from normal because of the higher frequency of female sex, antecedents of hiatus hernia, use of laxatives but not because of age nor by the number of associated symptoms. In conclusion, functional bowel disorders occurred in 20 p. 100 of our population; two subgroups were clearly different from an epidemiological point of view, the irritable bowel syndrome (13 p. 100) and constipation (7 p. 100); therefore these two groups deserve a specific physiopathological, psychological and therapeutic approach.
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PMID:[Epidemiology of intestinal functional disorders in an apparently healthy population]. 395 14

It is widely acknowledged that Barrett's esophagus in adults is an acquired condition resulting from prolonged gastroesophageal reflux. Barrett's esophagus is rare in childhood, even though gastroesophageal reflux occurs commonly in the pediatric age group. When a columnar-lined esophagus is present in children, it is often regarded as a congenital anomaly rather than as a consequence of chronic gastroesophageal reflux. Over a 5-yr period (1978-1982), we retrospectively studied Barrett's esophagus in children 19 yr of age or younger who were evaluated for gastroesophageal reflux and whose symptoms warranted esophagoscopy and esophageal biopsy. Esophageal biopsies were performed on 103 patients with gastroesophageal reflux. Thirteen children (age range, 8 mo-19 yr) had Barrett's esophagus, for a prevalence of 13%. Gastroesophageal reflux was documented in these children by upper gastrointestinal radiographs or pH monitoring. Radiographs demonstrated esophageal stricture in 5 of the 13 children; none had hiatal hernia. Children presented with symptoms suggestive of gastroesophageal reflux and esophagitis: vomiting, abdominal pain, odynophagia, dysphagia, and heartburn. All children had a past history of excessive regurgitation during infancy. Histologically, three types of columnar epithelium were present: gastric fundic type (11 patients), junctional-type columnar epithelium reminiscent of gastric cardia (7 patients), and specialized columnar (metaplastic intestinal) type (2 patients). We believe that Barrett's esophagus is more common in children than had previously been appreciated. In these children, we suggest that the distal columnar-lined esophagus resulted from chronic gastroesophageal reflux and is not a congenital anomaly.
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PMID:Barrett's esophagus in children: a consequence of chronic gastroesophageal reflux. 669 Mar 59

Excessive spontaneous swallowing has been associated with a variety of common gastrointestinal symptoms including abdominal pain, heartburn, and bloating and may contribute to disorders such as hiatus hernia, duodenal ulcer, and irritable bowel syndrome. The present study investigated the hypothesis that changes in emotional state alter spontaneous swallowing rate. Subjects were 38 generally healthy undergraduates assigned to either a pleasant low arousal, neutral, or aversive high arousal condition. Each experimental session was divided into 30-min baseline and arousal manipulation periods. Spontaneous swallowing rate increased significantly with emotional arousal: for low, neutral, and high arousal groups, means were 7.9 +/- 1.9 (SE), 15.8 +/- 2.4, and 23.7 +/- 3.6 swallows/30 min, respectively. Other physiological and self-report measures, used to check the effectiveness of the arousal manipulation, varied appropriately with experimental procedures. These results indicate that changes in emotional state alter spontaneous swallowing rate in generally healthy individuals. Further research with patients is needed to establish whether stress-induced increases in swallowing rate produce or exacerbate clinically significant gastrointestinal symptomatology.
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PMID:Spontaneous swallowing rate and emotional state. Possible mechanism for stress-related gastrointestinal disorders. 785 Nov 90

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

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

This report investigates the concept that severe constipation requiring major abdominal surgery may result from one of three common causes: 1) colonic inertia, 2) pelvic hiatal hernia, or 3) both colonic inertia and pelvic hernia. This study evaluates the symptoms, anatomy and outcome in 201 patients with severe surgical constipation treated by a single surgeon. In 2042 patients with constipation referred to one colon and rectal surgeon, 211 major abdominal surgical procedures were performed on 201 patients for severe constipation between 1989 and 1999. There were 187 women and 14 men. Mean age was 49 years (range, 9-84). Five high-risk patients had ileostomy; 196 had major colonic surgery for anatomic or physiologic causes of constipation, excluding malignancy, diverticular disease, and inflammatory bowel disease. Pelvic hiatal hernia was defined as the herniation of bowel through the hiatus of the pelvic diaphragm seen on pelvic videofluoroscopy or physical examination. Of these 196 patients, 44 per cent had pelvic hiatal hernia repair (PHHR), 27 per cent had total abdominal colectomy and ileorectal anastomosis for colonic inertia, and 29 per cent had surgery for both colonic inertia and pelvic hiatal hernia. Of the 144 patients undergoing PHHR, 95 had Gore-Tex patch (W. L. Gore and Associates, Inc., Phoenix, AZ) sacral colpopexy. PHHR for pelvic hiatal hernia without colonic inertia included sigmoid resection, rectopexy, and Gore-Tex patch sacral colpopexy. Mean duration of follow-up was 20 months. Symptoms noted preoperatively included abdominal pain (84%), straining at stool (90%), incomplete rectal emptying (85%), painful bowel movements (74%), pelvic pain (69%), vaginal bulge (55%), digital assistance with evacuation (35%), and incontinence of stool (38%). Outcome assessed by symptom relief was successful in 89.1 per cent of patients. 8.6 per cent of patient conditions were unchanged, and 2.3 per cent were unsatisfied with the outcome. There were no postoperative deaths. The complication rate was 6.1 per cent (small bowel obstruction, 7; anastomotic leak, 2; ureteral stenosis, 2; and patch erosion, 1). In our experience, severe surgical constipation can be due to colonic inertia, pelvic hiatal hernia, or both. Careful preoperative evaluation identifies these disorders, and surgical therapy aimed at correction of anatomic and physiologic defects results in high patient satisfaction and improvement in bowel function.
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PMID:Operative management of severe constipation. 1059 57

A postoperative hiatal hernia is a rare but serious complication of fundoplication. We report herein a 62-year-old female who presented with abdominal pain and vomiting 2 years following laparoscopic Nissen fundoplication. At laparotomy, the stomach and the transverse colon were intrathoracic (type IV hiatal hernia); the esophageal hiatus was markedly dilated with no evidence that they had been approximated. At 18 months follow-up, she is doing very well apart from occasional heartburn. A high index of suspicion is needed to diagnose postoperative hiatal hernias. A routine closure of the crura with nonabsorbable suture material and an avoidance of iatrogenic pneumothorax may help to reduce the occurrence of this problem.
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PMID:Type IV hiatal hernia post laparoscopic Nissen fundoplication: report of a case. 1129 11


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