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

Sclerosing encapsulating peritonitis is now a well-recognised, but uncommon, complication of chronic ambulatory peritoneal dialysis. Patients present with impaired ultrafiltration capacity, abdominal pain, nausea, vomiting and episodes of small bowel obstruction. Barium studies of the small bowel are characteristic, showing varying lengths of intestine tightly enclosed in a 'cocoon' of thickened peritoneum, proximal small bowel dilatation and an increased transit time. Ultrasonography may show a thick-walled mass containing bowel loops, loculated ascites and fibrous adhesions. With the increasing use of ambulatory peritoneal dialysis in the treatment of end-stage renal failure, it is important that this condition is recognised. The prognosis is poor when the bowel becomes obstructed; before this happens the offending 'sclerotic' membrane may be amenable to surgical removal.
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PMID:Sclerosing encapsulating peritonitis in chronic ambulatory peritoneal dialysis. 240 49

Primary intestinal lymphomas (PIL) include a number of interesting clinical and pathological subtypes with distinct geographic, socioeconomic and age distribution patterns. This report describes clinical and pathologic features of 37 Iraqi children with PIL seen 1965-1983. Three distinct groups were recognized: Mediterranean lymphoma, 11 patients, characterized by diffuse involvement of the proximal bowel; commonly presents with abdominal pain, diarrhea and malabsorption; Burkitt's lymphoma, 13 patients, characterized by localized tumor in the distal ileum or ileocecal region; commonly presents with intussusception, abdominal tumor and pain, and Non-Burkitt's lymphoma, 13 patients, usually occurs as localized tumors in the distal ileum; commonly presents with abdominal tumor, pain and intestinal obstruction.
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PMID:Primary intestinal lymphoma in Iraqi children. 242 21

We obtained follow-up information on 13 patients who underwent subtotal colectomy for severe idiopathic constipation 19-45 months previously. Stool frequency increased from one bowel movement per 11.5 days before colectomy to 5.3 bowel movements per day after colectomy. Nine patients have required readmissions for abdominal pain and four have required further surgery for symptoms of small bowel obstruction. Ten patients consider that their quality of life is improved, although five have variable amounts of fecal incontinence. Preoperative studies did not predict the three patients who failed to improve. Subtotal colectomy palliates constipation in most patients with severe idiopathic constipation but patients should be cautioned that not all improve and some are left with significant abdominal pain, obstructive symptoms, diarrhea, and fecal incontinence.
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PMID:Subtotal colectomy for severe idiopathic constipation. A follow-up study of 13 patients. 244

Carcinoid of the small intestine, usually found in the terminal ileum, presents a diagnostic challenge when the classic clinical and laboratory findings are absent. The commonest symptom, marked abdominal pain due to intussusception, may arouse suspicion of carcinoid. The precise preoperative diagnosis in the absence of the classic syndrome is impossible and the only way to diagnose it is by colonoscopic biopsy of the terminal ileum. The case described illustrates such a preoperative diagnosis in a 59-year-old woman with severe abdominal pain, nausea, vomiting and weight loss. X-ray studies aroused suspicion of tumor intussusception as the cause of the intestinal obstruction. Colonoscopic biopsy revealed the presence of a carcinoid tumor. However, there had been no symptoms of the carcinoid syndrome, nor was there increased urinary 5-hydroxy indoleacetic acid. On operation the tumor was found to be disseminated and unresectable, so surgical intervention was limited to palliative ileo-transversostomy.
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PMID:[Preoperative diagnosis of carcinoid of the terminal ileum in the absence of carcinoid syndrome]. 247 74

In an audit of 1190 emergency admissions with abdominal pain (1166 patients) in a general surgical unit, the diagnosis was non-specific abdominal pain (NSAP) in 415 (35 per cent), acute appendicitis in 200 (17 per cent) and intestinal obstruction in 176 (15 per cent). The largest number of admissions occurred in the age groups 10-29 years (31 per cent) and 60-79 years (29 per cent). Surgical operations were performed in 551 patients (47 per cent) and there was a 16 per cent incidence of unnecessary appendicectomy (22 per cent in the age group 20-29 years). Fifty-one deaths resulted in a 30-day hospital mortality rate of 4.4 per cent and a perioperative mortality rate of 8 per cent. The mortality rate increased significantly in patients aged greater than or equal to 60 years, and patients aged 80-89 years had a perioperative mortality rate of 20 per cent. The causes of perioperative death included laparotomy for inoperable disease (28 per cent), ruptured abdominal aortic aneurysm (23 per cent), perforated peptic ulcer (16 per cent) and colonic resections (14 per cent). The perioperative mortality rates for ruptured aneurysm and perforated ulcer were 71 and 23 per cent respectively. The duration of inpatient stay increased significantly with the age of the patients, including those with NSAP. The results of the study indicate a need to review the methods of management of ruptured aortic aneurysm and perforated peptic ulcer, the methods of diagnosis of appendicitis, particularly in young females, and the factors that determine the duration of stay of patients suffering from NSAP.
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PMID:Abdominal pain: a surgical audit of 1190 emergency admissions. 259 64

The authors present one case of intestinal obstruction by volvulus of the cecum. The patient had abdominal pain for 4 days. This pain was colicky in nature and of greatest in density in the left iliac fossa. He was nauseated, had anorexia, and had been vomiting. Abdominal distension was present. Plain-roentgenogram of the abdomen showed an enormously distended gas-filled intestinal loop in the upper abdomen just to the left of midline. At surgery there was volvulus of the cecum located in the upper abdomen to the left of midline. The cecum was viable and was relocated in the right lower quadrant and secured to the antero-lateral abdominal wall (cecopexy). The patient made a good postoperative recovery.
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PMID:[Volvulus of the cecum. A case report]. 260 86

A 40-year-old patient with clinical manifestations of impaired general status, abdominal pain and signs of malabsorption of six months duration was diagnosed as adult celiac disease. Treatment was initiated with a gluten-free diet and there was improvement. Later, in spite of the patient's compliance with dietary treatment, he suffered two episodes of intestinal obstruction. In the first episode the symptomatology remitted with intestinal rest, parenteral feeding and steroids, but clinical manifestations persisted in spite of medical treatment so exploratory laparotomy was realized. On pathological study were found ulcers that affected the mucosa and submucosa, inflammatory infiltrate without granulomas, and partial villous atrophy in the adjacent non-ulcerated mucosa, all compatible with a nongranulomatous ulcerative enteritis. The course was torpid and the patient died in a few months.
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PMID:[Chronic ulcerative enteritis. Apropos of a case]. 261 60

A case of distal volvulus of the stomach as a cause of acute intestinal obstruction in a paraesophageal hernia is presented. The patient, an old woman aged 82, had been suffering from abdominal pain and vomiting for about 48 hours. She successfully underwent emergency operation for the reduction of hernia and plasty of the hiatus anterior the esophagus. On the basis of personal experience and review of literature data, stress is laid on the high incidence of paraesophageal hernia complications and the importance of early diagnosis and surgical repair is underlined.
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PMID:[Distal gastric volvulus as a cause of acute occlusion in paraesophageal hernia. Considerations on a clinical case]. 262 60

In conclusion, the most important task in evaluating an immigrant or traveler with abdominal pain is to consider the myriad tropical diseases that mimic common western conditions. A careful history may point to antecedent symptoms and a time course that are incompatible with typical appendicitis, biliary colic, or bowel obstruction, but physical examination is generally not specific enough to differentiate between tropical and ordinary abdominal crises. Blood work for eosinophilia and a rapid examination of the stools by an experienced technician may indicate a need for judicious delay in exploratory laparotomy. In this interval, imaging studies, serologic tests, and therapeutic drug trials may clarify the diagnosis.
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PMID:Tropical medicine and the acute abdomen. 266 58

The authors present a case report of a sickle cell patient with end-stage renal disease treated with peritoneal dialysis who presented with abdominal pain. Although the pain was not unlike that typically associated with his crises, the absence of characteristic joint and chest pain made the diagnosis of "crisis" unlikely and favored the admitting diagnosis of peritoneal dialysis-related peritonitis. After the patient failed to improve with a medical regimen, including antibiotics, surgical consultation was obtained. Complete small bowel obstruction and diffuse peritonitis necessitated emergency surgery at which necrosis of terminal ileum was encountered. Histologic study of the resected specimen showed microvascular thrombosis with sickled erythrocytes. The authors review this rare complication and discuss the clinical problems of diagnosing typical and atypical abdominal pain in the sickle cell patient with and without concomitant crisis.
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PMID:Ischemic intestinal necrosis as a cause of atypical abdominal pain in a sickle cell patient. 268


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