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

A 46-year-old woman presented with abdominal pain, nausea vomiting and abdominal distention. Small bowel x-rays and CT scan of the abdomen revealed small bowel obstruction due to malignant melanoma. The diagnosis of cutaneous melanoma was performed 8 years prior to admission on one lesion in the back. Patient received surgical treatment. Completed resection of an involved jejunal [correction of ileal] segment was performed. Three tumor masses were found at laparotomy. Metastasis from malignant melanoma at the gastrointestinal tract occurs frequently though rarely are these intestinal lesions symptomatic. The efficacy of surgical treatment for symptomatic metastatic melanoma is justified to relief symptoms and prolonged survival.
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PMID:[Symptomatic malignant melanoma of the small intestine]. 134 Nov 16

About 15-20% of the time uterine surgery via laparotomy is replaced in our department by operative pelviscopy. Of these, in reference to myoma surgery, about 70% were tackled with operative pelviscopy and a laparotomy was avoided. This allows the preservation of the uterus, especially for those women who desire to bear children in the future. Organ-preserving, minimally invasive surgery is the current accepted operative ideal. Postoperative sequelae like adhesion formation, subacute intestinal obstruction, and chronic abdominal pain are thus decreased. The importance of correct and safely functioning equipment and instruments cannot be overstressed for optimal results. A closed drain, i.e., the Robinson drainage system, can be kept in place for at least 12-24 h to check the postoperative ooze. In two cases of extensive ooze, repeat pelviscopy was performed within 12 h and hemostasis was achieved by the use of endosutures and endocoagulation.
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PMID:Pelviscopic uterine surgery. 134 75

Intussusception is one of the leading causes of bowel obstruction in early infancy and childhood. From 1984-1989, 67 patients under 2 years of age with intussusception were diagnosed and treated in our institution. There were 48 boys and 19 girls ranging in age from 2 months to 2 years with a mean of 7.4 months. Presenting symptoms and signs included abdominal pain (96%), vomiting (93%), rectal bleeding (60%) and a palpable mass (67%). Symptoms and signs were present for less than 24 hours in about 80% of cases. Most of the intussusceptions were of the ileocolic type (75%). The overall success rate of hydrostatic barium enema reduction was 49%. The highest rate of reduction by enema was among patients between 9 and 16 months of age (83%). The success rate of barium enema reduction was negligible after 24 hours of cardinal symptoms. Five children underwent surgical exploration without contrast studies because of delayed presentation and signs of an acute abdomen. A pathological lead point was found in only four cases, the commonest being Meckel's diverticulum. The average length of hospitalization was 2.57 days after barium enema reduction and 7.55 days after surgical reduction. There were no deaths. There was no case of perforation during enema reduction. Three children had recurrence within 3 months of initial presentation. The best outcome is associated with early diagnosis and barium enema reduction, or selected surgical intervention when indicated.
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PMID:Intussusception in children under 2 years of age in the State of Qatar : analysis of 67 cases. 137 79

A new case of ileal inflammatory fibroid polyp (IFP) is reported. A 76 years old woman presented with abdominal pain due to intestinal obstruction; an ileo-ileal intussusception caused by an ulcerated submucosal polyp was found at laparotomy. The IFP usually appears as a solitary benign lesion, rarely located in the ileum. It is made up of fibrous tissue with a dense infiltrate composed predominantly of eosinophils.
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PMID:[Inflammatory fibroid polyp of the ileum]. 138 44

Clinico-pathologic analysis of 60 patients with primary malignant lymphoma of the small intestine and mesentery is presented. It occurs mainly in the adult. Both of these two tumors were first presented by abdominal pain and mass. Secondary anemia was common. They were complicated by intestinal obstruction, perforation or intussusception. The prognosis was aggravated by a large tumor mass, advanced stage and pathology of diffuse large cell subtype. Combined surgery, chemotherapy and radiotherapy were effective.
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PMID:[Clinico-pathologic analysis of 60 patients with primary malignant lymphoma of the small intestine and mesentery]. 139 61

Fifty-one children under the age of 10 years admitted to a general hospital in Trinidad had a confirmed diagnosis of malrotation of the intestines. This was the primary diagnosis in 20 cases. Analysis of the records of these 20 revealed that one-half were less than 1 month of age at first presentation. Vomiting was a universal complaint, and nearly two-thirds were malnourished. Disturbed bowel habit, anorexia and abdominal pain were also reported. In 30% (six of 20) there were signs of dehydration; an equal number had features of intestinal obstruction. Radiological investigation provided the diagnosis in all but one child, who underwent surgical exploration with a provisional diagnosis of appendicitis. Although a volvulus was found in 35% of cases, no resections were necessary. A high rate of morbidity and a mortality rate of 15% highlight the problems involved in the surgical care of young infants.
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PMID:Intestinal malrotation in Trinidad. 140 41

Intestinal obstruction is a rare but serious complication of pregnancy with significant maternal and fetal mortality. The reported incidence of intestinal obstruction complicating pregnancy varies widely, from 1 in 66,431 to 1 in 1,500 deliveries. A retrospective review of 66 cases of intestinal obstruction complicating pregnancy and the puerperium, including 2 cases from our institution, revealed that the most common causes of mechanical obstruction were adhesions (58%), volvulus (24%), and intussusception (5%). Seventy-seven percent of the patients with obstruction due to adhesions had undergone previous abdominal or pelvic surgery. Presenting symptoms and signs were similar to those of the nonpregnant patient; abdominal pain was present in 98% of patients, vomiting in 82%, and tenderness to palpation in 71%. In 82% of patients, obstruction was evident on radiographic evaluation. Prompt management of obstruction is essential; the median length of time from admission to laparotomy in the 66 patients was 48 hours. Bowel strangulation requiring resection was present in 23% of patients. Thirty-eight percent of patients completed term pregnancies after operative resolution of obstruction; total maternal mortality was 6%, and total fetal mortality 26%. Thus, both mother and fetus are at risk when intestinal obstruction complicates pregnancy. Clinical suspicion of the presence of obstruction and aggressive intervention are required to decrease the morbidity and mortality of this rare complication of pregnancy.
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PMID:Intestinal obstruction complicating pregnancy. 141 49

False aneurysm of the infrarenal aorta was found at the site of proximal anastomosis in 13 patients after vascular reconstruction for lower limb arterial disease. The grafts involved were aortoprosthetic in one patient, aortobiiliac in two patients, and aortobifemoral in 10 patients. They had been implanted eight years prior to reoperation on the average (range six months to 15 years). False aneurysm was diagnosed because of abdominal pain in four cases, embolism in two cases, intestinal hemorrhage in one case, and during routine sonographic or computed tomographic (CT) scan surveillance in the six other cases. Femoral false aneurysm was associated in eight of 10 cases with femoral anastomoses. Aortic false aneurysms were repaired by interposition of a prosthetic tube between the infrarenal aorta and the original prosthetic graft in 11 cases and by changing the aortobifemoral graft in two cases. In one further case, repair was accomplished by implanting an aortobifemoral prosthetic graft laterally on a prosthetic tube interposed between the infrarenal aorta and the body of the original prosthetic graft, which continued to irrigate the internal iliac arteries. There was no mortality. Thrombosis of a prosthetic branch occurred in one case and was treated by thrombectomy. One patient underwent reoperation for intestinal obstruction. Two others had distal embolism responsible for toe necrosis. Anastomotic false aneurysms should be looked for routinely during the surveillance of prosthetic grafts implanted on the infrarenal aorta, especially when femoral false aneurysm is found. Preservation of pelvic vascularization must be an integral part of management.
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PMID:Aortic false aneurysms after prosthetic reconstruction of the infrarenal aorta. 146 79

Isolated, small bowel metastases from lung carcinoma are extremely rare; only 34 cases have been previously reported. Rarer still is the presentation of lung carcinoma with a lesion metastatic to the small bowel. These 34 cases and 3 recent ones from Easton Hospital (Easton, PA) were analyzed to clarify the clinical and pathologic features of the disease. The majority of patients had a history of abdominal pain (86%), melena (23%), or nausea and vomiting (26%). Few had weight loss (16%). Twenty-one patients (57%) came to the hospital with perforation and peritonitis, including 9 in whom lung carcinoma was undiagnosed before laparotomy. Thirteen patients (34%) underwent laparotomy because of small bowel obstruction, 2 (6%) for bleeding and 1 (3%) for a mass found during work-up. Squamous cell (49%) and large cell (22%) were the most common cell types, and the jejunum was the most common site of the metastases (79%). Survival time was dismal (mean 51 days) and was unaffected by therapy to the primary site of the cancer or its metastases. The authors conclude that small bowel metastases from lung carcinoma are not uncommon and may be seen more frequently as patients live longer after their diagnosis of cancer. Small bowel metastases must be considered in any patient with both lung carcinoma and abdominal pain, and should be expected in patients with both lung carcinoma and an acute abdomen.
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PMID:Small bowel metastases from primary lung carcinoma: a rarity waiting to be found? 148 99

Intestinal occlusion is a rare pathologic event during pregnancy occurring mostly in the second and third trimenon when increased volume of the uterus and the consequent displacement of abdominal organs cause complications of pathologies which would otherwise escape notice, such as intestinal adhesions, to become manifest. Diagnosis is difficult for a number of reasons. Vomiting during the first trimenon and mild abdominal pain during the third are often neglected or considered to be part of the normal course of pregnancy; pain is sometimes referred to atypical sites due to the displacement of abdominal organs; in other cases, the high endorphin tonus is apt to reduce the customary defence reaction. All this should not cause time to be lost, and whenever intestinal occlusion is suspected all the necessary diagnostic procedures must at once be carried out and appropriate therapy must speedily be started so as to reduce the risk of mortality and morbidity for mother and fetus. Management of ileus in pregnancy is identical to that for the non pregnant woman, except for the need to empty the uterus in cases in which it prevents treatment or if the fetus has reached a sufficient degree of pulmonary maturity. The paper describes a case of ileal volvulus and revisits the literature analyzing the diagnostic and therapeutic options suggested.
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PMID:[Intestinal volvulus in pregnancy]. 149 64


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