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

The clinical and pathologic features of three cases of surgically removed myelolipoma of the adrenal gland are presented. As with 18 previously reported cases, the lesions were found in obese, middle-aged persons; two of three had chronic, systemic disease (vasculitis and lymphoma, sustained hypertension). The only symptom possibly attributable to the neoplasm was nonspecific abdominal pain, and each lesion was identified by inferior renal displacement on intravenous urography. As computed tomography becomes widely available, the authors expect more myelolipomas to be detected that require surgical exploration, since there are no satisfactory, specific radiographic criteria to differentiate adrenal myelolipoma from adrenocortical carcinoma.
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PMID:Myelolipoma: an unusual surgical lesion of the adrenal gland. 705 29

Since 1978 a diagnosis of left renal venous hypertension has been established in 3 patients. All 3 had otherwise unexplained left flank and abdominal pain, 2 had left renal gross hematuria, and 2 were found to have ureteral and peripelvic varices demonstrated by selective renal venography. All were found to have mild to moderate pressure gradients between the left renal vein and vena cava, presumably due to compression of the left renal vein between the aorta and overlying superior mesenteric artery. Direct left renocaval reimplantation was performed in all cases, with resection of the collateral varices that were present in 2 cases. Severe unrelenting pain was the primary indication for surgery in all cases, rather than hematuria. All remain asymptomatic one to four years after surgery.
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PMID:Left renal venous hypertension "nutcracker" syndrome. Managed by direct renocaval reimplantation. 714 3

After an upper respiratory tract infection an eight months old infant developed a severe hemolytic uremic syndrome with anemia, thrombocytopenia and anuria. Remarkable was a lesion of the erythrocytes by neuraminidase producing microorganisms. By early hemodialysis, blood transfusions and accurate fluid therapy the acute stage could be managed. The proceeding course was complicated by hypertension, seizures, coma, abdominal pain attacks and a fibrinous hemorrhagic pericarditis, which made an incomplete pericardectomy necessary. Although it came again to diuresis a severe chronic renal failure with its concluding effects as anemia, acidosis, hypertension and inanition resulted. After a four months period the patient died of biventricular congestive heart failure.
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PMID:[Severe course of a hemolytic-uremic syndrome]. 715 51

Segmental infarction of the omentum is an unusual cause of the acute or "semi-acute" abdomen. Because of its rarity, the nonspecificity of its signs and symptoms and the almost total lack of information regarding its natural history, it is very rarely diagnosed correctly prior to laparotomy or autopsy. We report a 51-year old obese woman with chronic hypertension, congestive heart failure and renal insufficiency, who developed recurrent severe abdominal pain. The diagnosis of primary omental disease was entertained because of the triad of persistent localized abdominal pain, lack of grossly disturbed visceral function and the presence of hemoperitoneum. This was confirmed by laparotomy.
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PMID:Segmental infarction of the omentum: a cause of the semi-acute abdomen. 723 23

A patient who presented with severe abdominal pain was found to have an intrahepatic haematoma complicating previously undiagnosed polycythaemia vera (PV). Full recovery followed treatment with bed rest, control of hypertension, daily venesection and 32P. The hazards of surgery in uncontrolled PV are discussed and re-emphasized.
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PMID:Polycythaemia vera presenting as an acute abdomen. 730 73

The records of all patients with solitary renal artery aneurysms seen between January 1968 and December 1978 were reviewed. Patients with fibromuscular dysplasia were excluded from analysis. Of the 67 patients seen, 34 had the diagnosis made on the basis of arteriography, 31 on the basis of abdominal roentgenography, and 2 at surgery. The ages of the 67 patients (34 men and 33 women) ranged from 21 to 90 years, with a mean of 61 years. Only five patients (8%) were symptomatic; all five presented with abdominal pain. Forty-six patients (69%) had associated hypertension. Five patients underwent surgical repair when initially seen. Only one patient had preoperative abdominal pain that was considered to be related to the aneurysm. The aneurysm sizes ranged from 0.3 to 4.0 cm, with a mean of 1.5 cm. In 45 patients (67%) the aneurysm was calcified. Follow-up ranged from 1 to 17 years, with a mean 5.7 and a median of 8.0 years. During follow-up, all aneurysms remained clinically silent. No aneurysms were subsequently repaired, no new cases of hypertension developed, no nephrectomies had to be performed, and no ruptures occurred. Eight patients (12%) died; no death was related to a complication of the aneurysm. This study supports the view that patients with asymptomatic solitary saccular renal artery aneurysm may be safely observed without surgical intervention.
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PMID:Solitary renal artery aneurysm. 742 76

We report the 14th case of myelolipoma of the adrenal gland. Recommendations for appropriate diagnostic and therapeutic methods are made. Myelolipoma of the adrenal gland is a rare non-functioning tumor composed of lipoid and hematopoietic elements. The most consistent complaint is abdominal pain caused by hemorrhage within the tumor. We identified an association with obesity and hypertension. Ultrasound combined with computed tomography is useful in diagnosis. With expanded use of these studies, myelolipoma will be recognized more frequently. Definitive diagnosis and treatment are accomplished by simple excision; radical surgery is unnecessary.
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PMID:Myelolipoma of the adrenal gland. 745 51

Three cases of unexpected clinical course of ruptured aortic aneurysm have been presented in patients of their 7th decade life. All of them had arterial hypertension. Signs and symptoms on admission to hospital (dysphagia, chest and interscapular pain, hematemesis, abdominal pain, elevated body temperature and diminished exercise tolerance) were non-specific of aortic aneurysm, suggesting other disease. Dramatic clinical course with hypovolemic shock in two cases led to death. One of them refused surgery. In the third one, in spite of blood effusions to pleural cavity, pericardial sac and mediastinum, effective hypotensive therapy with a preservation of the slow heart rate and fluid evacuation from pericardial sac, gave the opportunity to perform elective surgery. Aortic dissection often presents an atypical course and when suspected, all available imaging technics including computed tomography and nuclear magnetic resonance must be used.
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PMID:[Unusual clinical course of ruptured aortic aneurysms--report of three cases]. 747 37

Three cases of unexpected clinical course of ruptured aortic aneurysm have been presented in patients of their 7th decade life. All of them had arterial hypertension. Signs and symptoms on admission to hospital (dysphagia, chest and interscapular pain, hematemesis, abdominal pain, elevated body temperature and diminished exercise tolerance) were non-specific of aortic aneurysm, suggesting other disease. Dramatic clinical course with hypovolemic shock in two cases led to death. One of them refused surgery. In the third one, in spite of blood effusions to pleural cavity, pericardial sac and mediastinum, effective hypotensive therapy with a preservation of the slow heart rate and fluid evacuation from pericardial sac, gave the opportunity to perform elective surgery. Aortic dissection often presents an atypical course and when suspected, all available imaging technics including computed tomography and nuclear magnetic resonance must be used.
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PMID:[Unusual clinical course of ruptured aortic aneurysms--reports of three cases]. 747 21

Headache either as an isolated syndrome or as part of a symptomatic grouping is a frequent reason for medical consultation or hospitalization during childhood and adolescence. We review 94 clinical histories of patients between three and thirteen years of age. Headache was the reason for being hospitalized in all cases. Our aim was to assess its incidence rate, epidemiology, clinical characteristics and etiology in addition to evaluating as to whether complementary examinations carried out during hospitalization were worthwhile. Among the most significant results were the following: age (73 patients were over seven years old, 77.6%), time elapsed for symptomatology to evolve (exactly or less than one week in 45% of cases); family history of migraine in 55 cases (58.5%). The most frequent accompanying symptoms were vomiting (38.2%), nausea (22.3%) and abdominal pain (19.1%). Physical exam was normal in 63 cases (67%) while sixteen patients (17%) had neurological focal signs and/or signs of endocranial hypertension (ECHT). Electroencephalography was performed on 94.6% of the patients and proved pathological in 22 cases (25%). Brain computerized tomography (CT) scan was carried out on 92.5% of the patients with space occupying lesions in 3.2% of the cases. The most frequent final diagnosis (52% of patients) was one of migraine. We did not find any patients with intracranial expansionary processes not showing signs of ECHT and/or neurological focalization, for which reason we doubt the profitability of the almost routine practice of carrying out brain CT scan on patients when severe headache is the sole symptom and where there are no specific findings during physical examination.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A retrospective study of infant headache]. 749 36


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