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

The authors describe 2 cases of duplication of the colon. One was discovered by accident and not treated. The other occurred in a patient with a long story of abdominal pain and had been operated twice with signs of intestinal obstruction. A partial resection of the duplication with the adjoining bowel segment was performed and the digestive tract was reconstructed bij and end-to-end anastomosis. The different forms of duplication are described with their specific features and the current theories about their mode of formation. Finally a brief description of the symptoms and of the available surgical techniques is given.
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PMID:[Duplication of the colon in the adult (author's transl)]. 70 69

Two cases of primary small bowel tumors causing an acute intussusception are presented. In one case two polyps were found and in the other case a lipoma in the wall of the jejunum. In both cases there were symptoms of recurrent bowel obstruction for several months before the acute condition. Although intussusception caused by a benign tumor of the small bowel is a rare condition it should be taken into consideration in the differential diagnosis of abdominal pain of doubtful origin.
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PMID:Recurrent small bowel obstruction caused by a benign tumor. A report of two cases. 70 94

An illness characterized by recurrent episodes of small bowel obstruction is described. The patient, a 79-year old gentleman has been followed for 20 years. During this time he has hospitalized 19 times. Extensive investigation, including three exploratory laparotomies, have failed to show a cause of the bowel dysfunction. The clinical findings have been similar on each admission. Cramping abdominal pain, vomiting, obstipation often followed by diarrhea, tender distended abdomen, high pitched bowel sounds and abdominal x-rays revealed dilatation of small and large intestine and delayed gastric emptying on various admissions. The failure to demonstrate a recognized etiology for the repeated bowel obstruction over a long period of time warrants a clinical diagnosis of chronic idiopathic intestinal pseudo-obstruction (C.I.I.P.). The age of the patient at the onset of symptoms and the duration of the dysfunction prompted a review of the literature. Twenty-seven reported cases allowed a comparison of this case with the clinical features previously described. Symptomatic therapy, consisting of small bowel decompression by intestinal intubation during the acute episode, was followed by the use of elemental diets given slowly and continuously during the convalescing period. The patient continues to be comfortable and able to maintain his body weight between episodes which, however, seem to be increasing in frequency.
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PMID:Chronic idiopathic pseudo-obstructive bowel disease. 71 82

The clinical and histopathologic features in seven patients with intestinal lymphoma are reported. Three of these presented with ulcerative jejunitis and four with overt lymphomas. A short history of abdominal pain with weight loss followed by intestinal obstruction, hemorrhage, or perforation characterized all the patients except one in whom a nine year history of malabsorption preceded the acute phase of the disease. Malabsorption was demonstrated in four of the patients, and all showed villous atrophy with crypt hyperplasia of the jejunum remote from areas of ulceration or frank lymphoma. The malignant lymphoma cells showed varying degrees of pleomorphism and exhibited phagocytosis of platelets, red cells, and cell debris. The accompanying infiltrate of inflammatory cells often overshadowed the neoplastic histiocytes, and in those cases showing little pleomorphism these cells could be easily overlooked. In the intestine the tumor cells were usually present as a diffuse infiltrate in the lamina propria or within the bases of ulcers and in five of seven cases did not give rise to macroscopic tumor masses. In all patients dissemination of tumor cells to the lymph nodes, liver, spleen, and bone marrow was evident, the infiltrate in all these organs resembling that seen in malignant histiocytosis. The morphology of the tumor cells, their phagocytic nature, the diffuse character of the tumor infiltrate, and the pattern of dissemination suggest that this lesion should be designated malignant histiocytosis of the intestine rather than histiocytic lymphoma (reticulum cell sarcoma). It is suggested that the tumor may arise from cells of monocyte-histiocyte lineage normally present in the lamina propria of the gut and that a prolonged cryptic phase accompanied, and often overshadowed, by an inflammatory reaction may give rise to malabsorption and ulcerative jejunitis before overt lymphoma is manifest.
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PMID:Malignant histiocytosis of the intestine. Its relationship to malabsorption and ulcerative jejunitis. 73 Jan 48

Five adults with midgut nonrotation were treated at Tripler Army Medical Center between January 1, 1966 and January 1, 1974. These patients usually presented with vague epigastric or lower abdominal symptoms. Initial diagnosis was generally based on barium enema studies revealing an entirely left-sided colon. However, on upper gastrointestinal series the absence of a normal duodenal "c" loop with straightening is also seen. Duodenal obstructive bands are rarely documented radiographically. Surgical intervention is frequently delayed in these patients due to the "atypical" symptoms and lack of correlation of these symptoms with objective radiographic changes. The high incidence of associated duodenal ulcer disease, the frequent occurrence of bowel obstruction, the persistence of chronic abdominal pain in the untreated patients, and the resolution of symptoms after anatomic correction point to the need for an aggressive approach to treatment in those patients who have chronic recurrent symptoms secondary to midgut nonrotation.
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PMID:Midgut nonrotation in adults. An aggressive approach. 80 77

Twelve patients with meconium ileus equivalent complicating cystic fibrosis in the postneonatal period were seen at the Mayo Clinic in the years 1950 through 1975. In a child or young adult with known or suspected cystic fibrosis, the triad of recurrent colicky abdominal pain, a mass in the right lower quadrant, and mechanical intestinal obstruction provides a clue to diagnosis of meconium ileus equivalent. The clinical suspicion of meconium ileus equivalent may be confirmed by meglumine diatrizoate (Gastrografin) enema, which in most uncomplicated cases also serves as treatment.
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PMID:Meconium ileus equivalent complicating cystic fibrosis in postneonatal children and young adults. Report of 12 cases. 83 31

Nonischemic intussusception is defined as a variant of acute intussusception exhibiting less acute symptoms of abdominal pain, vomiting, and diarrhea in the older child, longer duration of symptoms (usually 4-14 days), signs of imcomplete bowel obstruction, and absence of intestinal ischemia. Over a 10 yr period (1964-1973) 20 children with this disease were treated without mortality or recurrence at three children's hospitals in Chicago, Illinois. The higher incidence of diarrhea, the lower incidence of a palpable abdominal mass, and the lower incidence of blood per rectum in nonischemic intussusception predispose to diagnostic errors and delays in treatment. Despite the longer duration of symptoms, this variant of intussusception can be treated initially with a careful attempt at barium hydrostatic reduction. If this fails, easy operative manual reduction is the rule.
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PMID:Nonischemic intussusception. 89 56

We describe a patient with symptomatic multiple lipomas with volvulus. He complained of gradually increased abdominal pain and distention. Preoperative roentgenograms showed many rounded filling defects of the small intestine. Operation was performed to reduce intestinal obstruction and ileal resection was performed. The dilated ileum was rotated 720 degree clockwise and it contained 115 submucosal and 26 subserosal lipomas. Histologically, the lipomas were benign and consisted of well-developed fat tissue. The patient's postoperative course was satisfactory, and neither residual lipoma nor recurrence were found at barium enema examination two years after operation.
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PMID:Multiple lipomas of the ileum with volvulus. 90 Nov 89

The clinical and radiographic manifestations of intramural gastrointestinal hemorrhage are presented together with a review of the literature. The observations described are based on the analysis of 20 cases affecting different segments of the gastrointestinal tract. The pathologic process is induced principally by anticoagulant therapy, bleeding diathesis, or abdominal trauma and occurs as a localized, well-defined, intramural mass or as a more diffuse segmental involvement. The clinical features are nonspecific and can vary from mild crampy abdominal pain to severe shock. Other manifestations include rebound tenderness, muscle guarding, and small bowel obstruction. The duodenum and small bowel are the most frequent sites of involvement. The intestinal mucosal folds may be prominent, stretched, and sharply defined or completely affaced, accompanied by a smooth narrowing. There is rapid clinical and radiographic remission with conservative therapy. Intestinal perforations and fibrotic strictures resulting in small bowel obstruction are a rarity, observed only in the posttraumatic variety.
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PMID:Intramural gastrointestinal hemorrhage. Clinical and radiographic manifestations. 108 19

Between 1 January 1988 and 31 December 1989, 525 patients were admitted to one hospital with a diagnosis of acute abdominal pain. Of these, 182 (34.7%) underwent an emergency operation and 14 (7.7%) of these patients subsequently died within 30 days. Death was due to intestinal obstruction in 69%, and there was a 28% mortality rate for emergency colonic resection. Non-specific abdominal pain (NSAP) was the most common diagnosis (36.0%), followed by appendicitis (14.9%) and urological causes (12.8%). There was an unnecessary appendicectomy rate of 25.0%. Admission with pain because of urological causes was over twice that of previous reports. Duration of stay increased greatly with age. Results from this study confirm the high mortality rate in the elderly from emergency colonic resection. Greater care in diagnosis and a conservative approach to appendicitis, with laparoscopy in females of reproductive age, may produce a lower unnecessary appendicectomy rate without an increase in morbidity. If the diagnosis of NSAP could be made earlier and patients discharged sooner, a large saving in resources would result. This early diagnosis is not yet possible.
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PMID:Abdominal pain as a cause of acute admission to hospital. 751 36


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