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

The aim of the present study was to elucidate the gastrointestinal manifestations of yersiniosis. During the period 1974 to 1983, Yersinia enterocolitica infection was diagnosed in 458 patients, by isolation from fecal samples or by antibody response. At first admission, 184 patients had abdominal pain; 200, diarrhea; 45, vomiting; and 36, weight loss. Ulcerative colitis was diagnosed in 7 patients, Crohn's disease in 2, and unspecific colitis in 11. Mesenteric lymphadenitis or ileitis were found in 43 of 56 patients at laparotomy. The patients were followed for 4 to 14 years (1987). Thirty-eight patients were readmitted with abdominal pain and 28 with diarrhea; these symptoms were significantly correlated with the corresponding symptoms at first admission. Chronic colitis was diagnosed in 4 patients, chronic weight loss in 12. A follow-up inquiry (380 patients) indicated that patients with right iliac fossa pain during the acute infection less frequently developed chronic abdominal complaints. Gastrointestinal symptoms are common in both the acute and chronic states of yersiniosis. The correlations between acute and chronic symptoms indicate that yersiniosis is a chronic disease. Immunologically competent individuals may profit by fighting the infection in the right iliac fossa. The relationship between yersiniosis and inflammatory bowel diseases may still not be settled.
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PMID:Acute and chronic gastrointestinal manifestations associated with Yersinia enterocolitica infection. A Norwegian 10-year follow-up study on 458 hospitalized patients. 154 97

We report a homosexual patient with the acquired immune deficiency syndrome (AIDS) and histopathologic evidence for cytomegalovirus (CMV) appendicitis in a patient with no prior history of CMV infection. The patient presented with right lower quadrant pain and intermittent fevers. The diagnosis of appendicitis was difficult to make in this patient because of the presumptive diagnosis of tuberculosis ileitis and the frequent presentation of abdominal pain with fever in AIDS patients. Although CMV colitis is frequently seen in AIDS patients, the prevalence of CMV appendicitis is exceedingly rare. The problems related to making a diagnosis of CMV appendicitis and the therapeutic management of CMV infections are reviewed.
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PMID:Cytomegalovirus appendicitis in a patient with acquired immune deficiency syndrome. 164 60

A 26-year-old woman came to hospital with an acute abdomen and a history of abdominal pain for about 6 months. She showed signs of peritonitis and ileus and underwent a laparotomy after initial diagnostic procedures. There was massive terminal ileitis with perforation and localized peritonitis. Resection of the affected bowel was performed over 5 1/2 h without surgical or anesthetic complications. Postoperatively several attempts were made to insert a venous catheter via the internal jugular vein, first on the right and then on the left side. The catheter was finally placed and was used for infusions, although there were some signs that indicated a possible arterial position. Neurological disturbances followed the end of anesthesia; 2 h later the catheter was removed because of arterial malpositioning diagnosed by a blood gas analysis. The patient developed brainstem and cerebellar infarctions and died 2 days later. The main postmortem finding was massive swelling and paleness of the cerebellum and brainstem with macroscopically unaffected supporting arteries. The other main arteries of the head and neck were also unremarkable, except for two healing punctures of the left common carotid artery. Further examination revealed an embolism at the top of the basilar artery. The source was macroscopically obscure; stereomicroscopic examination of the heart showed small dark spots behind one fold of the aortic valve caused by parietal thrombosis of the damaged endothelium. The tip of the misplaced catheter had entered this region and caused the lethal embolism.
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PMID:[Arterial misplacement of a central venous catheter with a fatal cerebral embolism]. 195 38

The clinical data of 97 patients with Yersinia enterocolitica infection during 1989 were evaluated. The diagnosis was made by positive culture, serology and/or detection of Yersinia antigens in biopsies. The enteric form (enteritis, abdominal syndrome, pseudo-appendicitis, ileitis and colitis) occurred in 66% of all patients, 10 (10%) had an extramesenteric form, 22 had arthritis and 6 had erythema nodosum. The mean age was 33.6 (SD 19.4) years. Abdominal pain was the syndrome most frequently observed (in 55%), followed by diarrhoea in 44% and malaise in 41%. The duration of the disease was shorter than four weeks in 37% and longer than eight weeks in 34%. Serotype 03 was most frequently isolated. The agglutination reaction was positive in 25%, false-positive in 7% and false-negative in 68%; 91% had specific IgA and IgG antibodies against two or more virulence proteins (Yops).
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PMID:[Clinical findings and diagnosis of Yersinia enterocolitica infections; a retrospective study in Friesland]. 173 36

The authors describe the course of Crohn's disease in two boys and six girls aged 11.1-15.6 years. In three patients with terminal ileitis and affection of the ascendent colon the disease is characterized by prolonged growth retardation, subfebrile temperatures, abdominal pain. For patients with granulomatous colitis, blood-stained diarrhoea is typical abdominal pain and loss of body weight. Three patients were treated first for idiopathic proctocolitis and only in the course of the disease the diagnosis of Crohn's disease was established. In 87.5% of the patients on admission anaemia was found and all patients had a varying elevated red cell sedimentation rate and CRP. The author draws attention to extraintestinal symptoms (dermal, ophthalmological, articular, somatic retardation) which precede in particular somatic retardation) which precede in particular in affections of the small intestine intestinal manifestations. Their erroneous interpretation may delay the establishment of the diagnosis of Crohn's disease. The author emphasizes the importance of basic laboratory examinations and examination by ultrasound for early detection of patients.
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PMID:[Clinical picture of Crohn's disease in children and adolescents]. 224 75

The authors retrospectively reviewed the records of 50 patients whose initial diagnosis of Crohn's disease was made after the age of 50 years on the basis of strict histopathologic criteria. Progress of the 32 women and 18 men with a median age of 60 years (range, 50 to 78 years) was followed for a median of 95.5 months (range, 81.1 to 236.6 months). The most common presenting signs and symptoms were abdominal pain (82 percent), diarrhea (70 percent), weight loss (56 percent), bleeding from the gastrointestinal tract (26 percent), abdominal mass (16 percent), and fistula (14 percent). Initial operations performed were ileocolic resection (38 percent), proctocolectomy (16 percent), small bowel resection (10 percent), colostomy (2 percent), and a variety of segmental resections of the colon (34 percent). The overall recurrence rate of disease in patients in whom all obvious disease was resected, based on distribution of disease, was 80 percent (ileocolitis), 38 percent (ileitis), and 35 percent (colitis). Crohn's disease more often affects the distal gastrointestinal tract in older age groups. After resection, however, the clinical course is similar to that of the younger population. The high recurrence rate of Crohn's colitis is probably a result of the large number of initial segmental resections.
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PMID:Clinical course of Crohn's disease in older patients. A retrospective study. 235 Sep 97

Anisakiasis is a zoonotic disease caused by the ingestion of larval nematodes in raw seafood dishes such as sushi, sashimi, ceviche, and pickled herring. Symptoms of anisakiasis include abdominal pain, nausea, vomiting, and diarrhea. Because symptoms are vague, this disease is often misdiagnosed as appendicitis, acute abdomen, stomach ulcers, or ileitis. Endoscopic examination with biopsy forceps has facilitated the diagnosis of gastric anisakiasis. Worms can be removed and identified, and a definitive diagnosis can be made. Patients generally recover with no further evidence of disease. Worms can become invasive, however, and migrate beyond the stomach, penetrating the intestine, omentum, liver, pancreas, and probably the lungs. Surgery is often necessary for treatment of invasive anisakiasis. With the increase in popularity of eating lightly cooked or raw fish dishes, the number of cases of anisakiasis may be expected to increase.
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PMID:Anisakiasis. 267 Jan 91

Endometriosis affects 8%-15% of all women, and of these 3%-37% have intestinal involvement. Affected women are typically of childbearing age and of low parity, with a history of cyclic abdominal pain and progressive dysmenorrhea. Endometriosis may involve the rectum and sigmoid, ileum, cecum, and appendix, generating symptoms suggestive of acute obstruction, appendicitis, ileitis, diverticulitis, or colonic carcinoma. Thus, this entity should be included in the differential diagnosis of recurrent abdominal pain and other episodic bowel symptoms in women of childbearing age.
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PMID:Intestinal endometriosis and its complications: case report and review. 267 1

Construction of a continent ileostomy or ileo-anal reservoir after (procto)colectomy has provided many patients suffering from inflammatory bowel disease-in particular ulcerative colitis or polyposis coli--with a major improvement in their social wellbeing. However, complications are rather frequent and pouchitis is one of the most important chronic ones, to be defined as the combination of bothersome clinical symptoms (abdominal pain, bloating, increased faecal output, sometimes fever) with evident endoscopic abnormalities of the reservoir ileal mucosa (oedema, reddened mucosa, minor flat up to large irregular ulcerations). The contribution of pouch biopsies is limited, because chronic inflammation is always demonstrable and evidence of acute inflammation is only rarely present. Although backwash ileitis does not promote the occurrence of pouchitis, the immunological mechanism might be highly comparable. Cultures of faecal content for specific pathogens is necessary; bacterial anaerobic or aerobic overgrowth appears to be of no major significance in the development of pouchitis. Nevertheless, a short-term course with metronidazole is nearly always effective, although recurrences are far from rare. In this situation a course of corticosteroid enemas or even maintenance therapy (2-3 wk) should be advised. Experience with mesalazine compounds is limited and should be expanded.
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PMID:Pouchitis (pouch ileitis). 270 14

We reported two cases of terminal ileitis caused by Yersinia enterocolitica (Y.e.). Y.e. was proven by stool culture in each case. They were admitted to the hospital complaining abdominal pain. They are examined by X-ray and endoscopy in the different time, and their examination revealed edema, coarse mucosa and varioliform elevated lesions with the passage of time.
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PMID:[Yersinia enterocolitis--report of two cases]. 275 26


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