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

Extensive radiographic evaluation of children with recurrent abdominal pain (RAP) is rarely diagnostic or cost-effective. The authors sought to define the role of laparoscopy in the evaluation of children with RAP. Fifteen children underwent laparoscopy for RAP in a 2-year period. Their mean age was 12 years (range, 6 to 16 years), 13 (87%) were female, and the mean duration of symptoms was 11 months (range, 2 to 60 months). Thirty-eight imaging studies (excluding plain films) had been obtained before laparoscopy, including 19 abdominal sonograms, 9 upper gastrointestinal series, four abdominal computed tomography scans, 3 barium enemas, 2 isotope scans, and 1 magnetic resonance examination of the head. Only two (5%) of these studies provided an accurate diagnosis. Eleven of the 15 children (73%) had positive findings diagnosed and treated laparoscopically. These included eight appendiceal abnormalities (in six patients), three Meckel's diverticula, one inguinal hernia, one urachal cyst, one para-fallopian tube cyst, and one adhesion to an appendectomy stump. Eight of 11 (73%) children with positive findings had immediate resolution of symptoms after laparoscopic treatment. Three children with pathological findings at the time of laparoscopy had persistent symptoms, which resolved completely within 4 months of the laparoscopy. Laparoscopy is an accurate technique for the evaluation and treatment of children with RAP. Its early application could provide economic benefit by eliminating many low-yield imaging studies and minimizing lost time from school.
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PMID:Laparoscopy for diagnosis and treatment of recurrent abdominal pain in children. 886 55

We report the case of a 41 year-old male who came to the emergency room with a complaint of abdominal pain, and was diagnosed to have an acute obstructive abdomen due to a right inguinal hernia incarceration. During surgery, an intestinal granulomatous inflammation was observed adhered to the hernial sac. The histopathologic study confirmed the diagnosis of tuberculosis. We present a review of the different clinical forms of intestinal tuberculosis and the difficulties encountered in the differential diagnosis of such, emphasizing the uncommon presentation described in our patient.
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PMID:Inguinal hernia incarceration as a form of intestinal tuberculosis. 898 86

Hernioscopy is laparoscopy traversing a hernial sac used in the course of traditional treatment for groin hernia and it may be both diagnostic or therapeutic. The technique involves dissecting the hernial sac followed by incision, and the creation of a pouch into which a trocar is passed to permit laparoscopy. Once detected an abdominal lesion can also be treated laparoscopically: adhesiotomy, debridement, biopsy etc. The indications to this technique are: strangulated hernia after reduction of the intestinal loop; contralateral diagnosis of inguinal hernia in infants; hernias accompanied by abdominal pain or subocclusive syndromes. For surgeons who adopt the traditional approach to the treatment of groin hernias this technique represents an unexpected addition to their armoury.
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PMID:Hernioscopy: technique and indications. 918 17

Five autopsy cases of sudden death caused by intestinal obstruction are reported. The causes of death of the cases were duodenal obstruction of impacted food stuff, ileocaecal obstruction caused by Crohn's disease, incarceration of inguinal hernia, intestinal obstruction caused by heterotopic pancreas and paralytic ileus. In three cases, the patient was in cardiopulmonary arrest on arrival at hospital, and in the remaining cases the patient died within 12 hours from the beginning of treatment; therefore, a correct clinical diagnosis was not made before the death in all cases. All the patients had from one to three days history of nausea and abdominal pain, major complications of intestinal obstruction. Among all cases, the duration from the onset to death was the shortest in the case of a patient complicated with schizophrenia. It is characteristic that the patients of all cases died suddenly and resuscitation was not successful. Regarding the laboratory data of a hospitalized patient, marked hemoconcentration and an increased level of BUN/Cr ratio and blood sugar were shown. The patient who died from duodenal obstruction caused by impacted food-stuff had suffered from depression for six years, and the patient who died from paralytic ileus had suffered from schizophrenia for about 23 years. In both cases, it is characteristic that the complaints of the patient were poorer than what would be expected. Furthermore, these patients had been taking medication of psychotic, anti-depressant and anti-parkinsonism drugs; therefore the combination of these drugs was thought to be reflected in the bowel movement.
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PMID:[Analysis of sudden death caused by intestinal obstruction]. 954 55

Mesenteric and retroperitoneal cysts develop from ectopic lymphatic tissue. Most of them present as symptomless abdominal swellings or are found coincidentally during abdominal operations. One third of patients may present with acute abdominal pain, and few may present with chronic abdominal pain. However, mesenteric cyst presenting as inguinal hernia is extremely rare. Only four cases have been reported in the English-language literature. The present case is the fifth, and only the second from this subcontinent. The treatment of choice is complete surgical excision.
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PMID:Mesenteric cyst--an unusual presentation. 960 5

Cryptorchid testis have a greater risk of malignant change than do normally descended testis. The undescended testis would also be susceptible to torsion by the mechanism of increase in testicular size. A 36-year-old man of torsion of malignant undescended testis is presented. He was diagnosed as having incarcerated inguinal hernia on his first visit to general surgeon due to acute left lower abdominal pain. At laparotomy, a 7.5 x 5.5 x 3.0 cm3, greyish tan color mass was found. The pathological diagnosis is choricarcinoma and teratoma, mixed germ cell tumor. We would emphasise that in any patient presenting with acute abdominal symptoms and an absent scrotal testis, the possibility of a complication of torsion of undescended testis should be considered.
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PMID:Torsion of a malignant undescended testis. 961 17

Laparoscopy has been shown to be a safe and effective method to establish or rule out a diagnosis in difficult clinical situations and, in selected cases, provide minimally invasive access for therapeutic procedures. Relevant indications for diagnostic laparoscopy in the pediatric population include evaluation of a contralateral patent processus vaginalis in a child with a known unilateral inguinal hernia, an impalpable testis, acute and chronic abdominal pain, staging in cancer, and evaluation of traumatic injuries. Selected articles concerning these and other uses of diagnostic laparoscopy published between December 1996 and November 1997 are the subject of this review.
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PMID:Diagnostic laparoscopy. 971 98

The purpose of this study was to evaluate the usefulness of exploratory laparoscopy in patients with chronic abdominal pain. Forty-six patients underwent diagnostic laparoscopy for abdominal pain of unknown origin during 1992-1996. The average duration of the symptoms was 3.5 years. Patients with known malignancy were excluded. Seventy-two percent of the patients had undergone previous abdominal or groin surgery. An organic disease was found in 68% of the laparoscopies. Adhesions were found in 29 patients, inguinal hernia in 2 patients, and abnormal mesenteric lymph nodes in 1 patient. Adhesiolysis was carried out in 24 patients. Eighty-nine percent of patients could be contacted for follow-up. Mean follow-up time was 19 months. Seventy-seven percent of patients who had undergone adhesiolysis considered the result good or beneficial. Sixty percent of all patients reported a beneficial outcome after laparoscopy. No major complications were noted. This retrospective study suggests that laparoscopy is a safe and useful procedure in the diagnosis and treatment of chronic abdominal pain.
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PMID:Laparoscopy for chronic abdominal pain. 995 Jan 27

An 85-yr-old male presented with complaints of a 40-lb weight loss and a dull left upper quadrant abdominal pain. He also complained of decreased appetite, generalized weakness, generally not feeling well, and a dull left upper quadrant abdominal pain that was not relieved by food. He had a ventral and a left-sided inguinal hernia. Laboratory investigations revealed iron deficiency anemia, the cause of which was not apparent despite extensive investigation including computerized tomographic scans, esophagogastroduodenoscopy, and small-bowel follow-through examination. Surgical exploration for possible angiodysplasia, malignancy, and/or mesenteric ischemia revealed an incarcerated hernia, and the histopathological examination of the surgical specimen revealed high-grade angiosarcoma. The tumor showed strong positivity for vimentin and CD31 and a focal positivity for Factor VIII and CD34. At that time he was found to have hepatic metastases. He was started on thalidomide as an experimental measure with no change in the performance status and increasing evidence of necrosis in the metastatic lesion.
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PMID:Angiosarcoma of the small intestine: a possible role for thalidomide? 1471 38

Laparoscopy under local anaesthesia (LULA) is a safe, feasible and well-tolerated procedure. LULA has been successfully used for such outpatient gynaecological procedures as diagnosis of chronic pelvic pain and sterilisation. Single studies have indicated that LULA can be performed for diagnosis of possible intra-abdominal catastrophe in ICU patients, appendectomy and preperitoneal inguinal hernia repair. LULA in abdominal surgery for diagnosis of conditions presenting with acute lower abdominal pain is being introduced at our institution. This paper describes the possible applications of LULA in current practice as well as the technical aspects of the procedure.
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PMID:[Diagnostic laparoscopy under local anaesthesia]. 1628 20


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