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

Jejunal intussusception in children is an uncommon form of intussusception often presenting with chronic intermittent abdominal pain and weight loss. Two cases of jejunal intussusception caused by enteric duplication are presented. It is concluded that in the absence of generalized small bowel disease, enteric duplication is the most likely cause of jejunal intussusception in children.
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PMID:Jejunal intussusception in children. 736 61

A case of pseudomembranous colitis is reported in which computed tomography (CT) played an important role in the diagnosis and differentiation from other causes of fever and abdominal pain. It is important to look for CT evidence of primary bowel disease when scans are performed for possible abdominal abscess, since these two conditions may present similar clinical features.
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PMID:Pseudomembranous colitis. 737 72

Peroral jejunal biopsies were performed in 63 adult patients from a population of 40,000. Twenty-two patients had definite pathologic biopsy findings; 20 of these had gluten-induced enteropathy. With the 15 previously known patients in the region, this makes a minimum prevalence of 1 per 1,143. Subtotal villous atrophy was found in 8 patients, whereas partial villous atrophy was found in 12 patients. The clinical picture varied considerably, borborygmia, diarrhoea, abdominal pain, and psychiatric symptoms being the most commonly encountered symptoms. Steatorrhoea was found in only two patients with subtotal villous atrophy. In all the remaining patients, including six with subtotal villous atrophy, the faecal fat excretion was normal. A low whole blood folic acid concentration was the most consistent laboratory finding, although some patients had values slightly above the lower normal limit. Anaemia was not pronounced. Iron deficiency, as measured by the erythrocyte protoporphyrin IX concentration, was not common. A high degree of clinical awareness and broad indications for jejunal biopsy-taking is recommended.
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PMID:Prevalence and clinical picture of adult gluten-induced enteropathy in a Norwegian population. 743 1

Patients often present to the surgeon with abdominal pain, tenderness, and fever. Many exhibit progressive sepsis due to abdominal pathology. Delay in diagnosis and treatment often occurs due to the use of multiple, time-consuming, expensive diagnostic studies. We delineate the use of diagnostic laparoscopy in subsets of patients in whom confusion exists as to the cause of abdominal sepsis--i.e., females in child-bearing years, elderly patients, obese patients, immunosuppressed patients, and patients with suppression of physical findings. The methodical assessment of the entire abdominal cavity is performed utilizing manipulation of the patient's position (Trendelenburg, supine, reverse Trendelenburg, left side up, right side up) and meticulous inspection of the entire small bowel. Diagnoses included acute appendicitis, gangrenous appendicitis, perforated appendicitis with peritonitis or abscess, gangrenous cholecystitis, ischemic bowel disease, perforating carcinoma of the colon, perforating diverticulitis with abscess or peritonitis, tubo-ovarian abscess, closed-loop small-bowel obstruction, megacolon, and perforation of the colon. Laparoscopic treatment of 96% of the patients was performed successfully and a laparoscopic-assisted approach was used in the remainder. There was one mortality (cardiac) and no major morbidity. The development of a Formal Diagnostic Exploratory Laparoscopic (FDEL) approach has aided in the assessment of each of the diagnoses of sepsis in the abdominal cavity. The diagnostic and therapeutic approach laparoscopically avoids extensive preoperative studies, avoids delay in operative intervention, and appears to minimize morbidity and shorten the postoperative recovery interval.
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PMID:Use of laparoscopy in the diagnosis and treatment of patients with surgical abdominal sepsis. 759 89

Neutropenic enteropathy and multiple myeloma. Neutropenic enteropathy (NE) is an acute entity with an aggressive clinical behavior. The most common reported association of NE is with neutropenic children under chemotherapy for leukemias and lymphomas, other less common causes include: neutropenic adults with treatment for autoimmune diseases, aplastic anemia, cyclic benign neutropenia or solid-neoplasms. There are two cases of NE associated to multiple myeloma (MM). There was a 62 year old man with MM diagnosed ten months earlier and under chemotherapy. He developed abdominal pain, nausea, vomiting, diarrhea and rectal bleeding three days before death. The autopsy study revealed ulcers and thickening of the colonic wall in 40% of the entire surface, and in 5% of the ileum. The microscopic analysis revealed mucosal and submucosal ischemic necrosis, and bacterial invasion without acute inflammatory response. As the two previously reported cases, he received vincristine and steroids a few days before developing neutropenia. This report shows the clinical and morphologic findings of the third case of the association of NE and MM, and the first one illustrated in Mexico.
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PMID:[Neutropenic enteropathy associated with multiple myeloma]. 763 36

We sought to prospectively characterize and compare the symptoms of children > or = 5 years of age with recurrent abdominal pain to previously established criteria for irritable bowel syndrome (IBS) in adults. For all eligible subjects, a detailed questionnaire concerning characteristics of abdominal pain and defecatory pattern was completed at presentation. In addition, a battery of screening tests was performed and additional evaluation was done at the discretion of their physician. In all, 227 subjects fulfilled the entrance criteria, but 56 were subsequently excluded because of diagnoses of inflammatory bowel disease (nine cases), lactose malabsorption (46 cases), or celiac disease (one case). Of the remaining 171 patients, 117 had IBS symptoms. In the IBS subjects, lower abdominal discomfort (p < 0.001), cramping pain (p < 0.0009), and increased flatus (p < 0.0003) were more common, whereas dyspeptic symptoms such as epigastric discomfort (p < 0.003), pain radiating to the chest (p < 0.009), and regurgitation (p < 0.02) were more common in the non-IBS subjects. Our study not only confirms the clinical heterogeneity of children with recurrent abdominal pain but also concomitantly demonstrates that most children with this disorder have symptoms that fulfill the standardized criteria for IBS in adults. The identification of subgroups of children with recurrent abdominal pain can provide a framework for the diagnosis of functional bowel disease as well as establish the need for invasive and expensive tests.
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PMID:Characterization of symptoms in children with recurrent abdominal pain: resemblance to irritable bowel syndrome. 913 90

Brown bowel syndrome is a rare intestinal disorder associated with the deposition of lipofuscin pigment in the smooth muscle cells. We report two such cases presenting with intestinal pseudo-obstruction, abdominal pain, and body weight loss. Both cases had malabsorption and fatty liver. Exploratory laparotomy revealed brownish discoloration of the small bowel wall and enlargement of mesenteric lymph nodes. Light microscopy, autofluorescence and ultrastructure studies confirmed the deposition of lipofuscin pigments in the intestinal muscle cells and reticuloendothelial cells of mesenteric lymph nodes. In addition, the calf muscle biopsy of case 1 displayed myopathy and fatty replacement. Skeletal muscle strength of both patients was partially restored after parenteral and oral vitamin E supplement and other conservative treatment, but gastrointestinal symptoms of both patients continued to deteriorate. Thus, brown bowel syndrome associated with prolonged and severe malnutrition and possibly vitamin E deficiency appears only partially responsive to vitamin E supplementation.
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PMID:Brown bowel syndrome: report of two cases. 791 59

Colitis is an important cause of abdominal pain and diarrhoea and is the main cause of blood and mucus in the stool. The inflammation can be due to infectious or to non-infectious causes, most commonly ulcerative colitis and Crohn's disease. However, a wide variety of rarer causes of colitis also present in childhood. These include colitis or enterocolitis secondary to Hirschsprung's disease and metabolic disorders (which include Hermansky-Pudlak syndrome, glycogen storage disease type 1b and pellagra). Primary inflammation of the colon is seen in microscopic and collagenous colitis, ulcerating enterocolitis of infancy, allergic colitis and autoimmune enteropathy. The histological pattern of each of these diseases has a characteristic picture and separates them from each other from ulcerative colitis and Crohn's disease. The pathophysiology of these rare forms of colitis in childhood is not clear; but in the future they may give us an insight into the pathogenesis of large bowel inflammation, particularly when the colitis occurs secondary to an established disease.
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PMID:Unusual colitides. 800 42

In order to examine the presentation and course of Crohn's disease (CD) versus those of ulcerative colitis (UC) in children < or = 10 years of age, a retrospective review of children < or = 10 years old with inflammatory bowel disease singled out 40 patients and compared their findings with those of 38 children with UC. The mean age at onset was 7.5 years for CD, as compared with 5.9 years for UC. A family history of inflammatory bowel disease was present in 13 patients (32%). Abdominal pain (97%), diarrhea (78%), and weight loss (88%) were the major initial complaints, with growth retardation present in 12 (30%) children. At onset, four children had diffuse small-bowel disease, nine had terminal ileal disease, 15 had ileocolitis, and 12 had colitis; at the end of the study two had diffuse small-bowel disease, four had terminal ileal disease, 25 had ileocolitis, and seven had colitis. Extra-intestinal manifestations increased with duration of disease. Although the number of recurrences did not differ greatly between groups, those with ileocolitis and colitis needed longer steroid therapy and more days in hospital than did those with only small-bowel disease. Operation was required in 42.5% of children with CD, as compared with 5% of those with UC, with six CD children (35%) requiring later reoperation for recurrent disease or fistula and abscess. Two children died from causes unrelated to their disease (gastric volvulus, carcinoma of the breast).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Crohn's disease in children 10 years old and younger: comparison with ulcerative colitis. 857 7

The purpose of our study was to determine if a normal small-bowel enteroclysis excludes small-bowel disease in adult patients, using long-term follow-up as the major reference standard. We reviewed 193 consecutive small-bowel enteroclysis (SBE) studies completed during a period from January 1987 to February 1989, of which 83 were judged to be normal at the time of the study. Eight of these latter patients were excluded due to inadequate follow-up. The indications included detection of gastrointestinal bleeding, small-bowel obstruction, Crohn's disease, nonspecific abdominal pain, chronic diarrhea, and a miscellaneous group. Each patient was followed for at least 3 years by chart review or until a definite diagnosis was established. Six of the 75 patients whose SBE was originally interpreted as normal were eventually judged to have small-bowel disease. The remaining 69 patients were judged to be free of small-bowel disease by autopsy, surgical laparotomy, endoscopic observation or biopsy, or long-term follow-up for at least 3 years. Therefore, a normal SBE correctly excluded small-bowel disease in 69 of our 75 patients (true negatives) and failed to diagnose disease in six patients (false negatives), for a specificity of .92 +/- .03 (SE). In this experience, SBE was sufficiently specific in most patients to exclude small-bowel disease.
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PMID:Does a normal small-bowel enteroclysis exclude small-bowel disease? A long-term follow-up of consecutive normal studies. 819 40


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