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

Mucocele of the appendix was first described and named "Hydrops processus vermiformis" by Rokitansky in 1866. Intussusception of a appendiceal mucocele is very rare and we have been able to find only 14 previously reported cases. We present two cases with preoperative ultrasonography which is valuable for its diagnosis. Case 1: A 5-year-old male was admitted to Kahoku Hospital because of right lateral colic abdominal pain and tumor. Ba-enema examination revealed intussusception to the colon and ultrasonography showed the cystic mass of the appendix. Case 2: A 51-year-old female was admitted because of right lower abdominal pain. Ultrasonography was helpful showing the cystic tumor at the base of the appendix. Recent reports say that ultrasonography is valuable examination for its diagnosis. Also in our two cases preoperative ultrasonography was performed and gave us valid information for its qualitative diagnosis.
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PMID:[Two cases of intussusception of appendiceal mucocele: diagnostic value of preoperative ultrasonography]. 352 15

A decreased level of consciousness with little abdominal pain or gastrointestinal symptoms is an uncommon, but well described, presentation of infantile intussusception. Its etiology is unclear. We describe a 10-month-old male who presented with coma and miosis, reversible with bolus injections of naloxone on three separate occasions. No opiates were involved and an intussusception was subsequently found. We speculate that the coma and miosis were induced by an endogenous opioid which could also mask the abdominal pain, thus explaining this presentation of intussusception. If so, miosis would be a valuable clue for diagnosing such children.
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PMID:Early coma in intussusception: endogenous opioid induced? 356 7

Intussusception in older infants is manifested by bloody stools, colicky abdominal pain and a palpable abdominal mass. In neonates the symptoms are often restricted to vomiting, guaiac positive stools and abdominal distension. These symptoms closely mimic necrotising enterocolitis. Surgical treatment of necrotising enterocolitis should be postponed until perforation of the gastrointestinal tract has occurred, whereas, prompt surgical treatment is recommended for intussusception. We report a case of intussusception that simulated necrotising enterocolitis in a 740 grammes premature infant in the second week of life. The clinical and radiographic features are described and the difficulty in distinction between the two conditions is emphasised. Neonatologists and paediatric surgeons should always include intussusception in the differential diagnosis of abdominal distension and guaiac positive stools in small premature infants.
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PMID:Intussusception in a premature infant simulating necrotising enterocolitis. 356 11

Expected clinical manifestations of intussusception include paroxysmal abdominal pain, vomiting, abdominal mass, and with time, rectal bleeding. We report a case where lethargy and vomiting are the presenting complaints. Diagnostic delay was encountered for this infant who had altered sensorium without accompanying pain, melena, or mass on initial examination. Either plain radiographs, supplemented by ultrasonography of the abdomen, or a barium enema should be performed in infants with unexplained lethargy.
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PMID:Intussusception: a supplement to the mnemonic for coma. 361 30

Intussusception remains a leading cause of bowel obstruction in early infancy and childhood. From 1970 to 1985, 83 patients with intussusception were treated. There were 51 boys and 32 girls ranging in age from 2 months to 22 years. Ten patients had a total of 14 separate recurrences; nine occurred during the initial hospitalization. Symptoms on presentation included abdominal pain (80%), palpable mass (60%), rectal bleeding (53%), and lethargy or sepsis (45%). Fifteen children underwent exploration without contrast studies based on duration of symptoms (greater than 5 days) and evidence of severe obstruction on plain abdominal x-ray films. In the remaining children, diagnosis was confirmed by barium enema and hydrostatic reduction was achieved in only 34 patients (42% success rate). Symptoms were present more than 48 hours in 55% of the reduction failures. At operation, five children had spontaneously reduced and an appendectomy was performed. Manual reduction was possible in 32 patients. The intussusception was irreducible in 26 patients, and 18 required temporary stomas. Pathologic lead points were found in 11 patients. Average length of hospitalization was 1.5 days after barium enema reduction, 9.6 days after manual reduction, and 13.8 days after bowel resection. There were no recurrences of intussusception after surgical reduction. A significant morbidity rate was observed with a delay in diagnosis. Adequate preoperative preparation and prompt surgical intervention are associated with 100% survival.
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PMID:Intussusception: current management in infants and children. 366 Feb 43

A 7-year-old boy developed recurrent abdominal pain. He was eventually discovered to have an inverted appendix via colonoscopy. At surgery, a polyploid intracecal mass was palpated at the base of the partially invaginated appendix. Resection of the cecal mass (histologically, a juvenile polyp) and appendix was easily accomplished. The types of clinical presentation and treatment of children with appendiceal intussusception are discussed.
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PMID:Cecal polyp and appendiceal intussusception in a child with recurrent abdominal pain: diagnosis by colonoscopy. 369 79

Generalized juvenile polyposis occurred in five patients (age range, 18 months to 16 years). Clinical findings included abdominal pain, weakness, rectal bleeding, diarrhea, rectal prolapse, intussusception, clubbing, and failure to thrive. Laboratory findings included anemia, hypoalbuminemia, hypokalemia, and skin test anergy. Diagnosis is achieved by double contrast enema, endoscopy, and biopsy. Unlike patients with solitary juvenile polyps, patients with generalized involvement require surgical intervention. Subtotal colectomy and ileoproctostomy are the procedures of choice, and we performed them in four cases. An ileoanal-endorectal pull-through procedure was required in one patient with continued rectal disease. All five patients are currently alive and well. Long-term follow-up is important as polyps may persist into adult life. Family members are at risk for developing gastrointestinal tract tumors and should be screened.
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PMID:Generalized juvenile polyposis coli. Clinical management based on long-term observations. 370 30

An intussusception of the small intestine in association with a long tube usually occurs in the vicinity of the mercury-filled bag and can be visualized radiographically by instilling barium directly into the tube. On rare occasions, an intussusception develops in the proximal jejunum and is difficult to recognize. We report the fifth and sixth cases of a proximal jejunal intussusception with a long tube in situ and outline a clinical approach that facilitates a prompt, accurate diagnosis. A proximal jejunal intussusception should be suspected if copious bilious vomiting and abdominal pain occur following intubation of the small intestine with a long tube.
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PMID:Proximal jejunal intussusception associated with a long tube. 370 30

During a 14 year period, 27 of 310 horses undergoing laparotomy because of abdominal pain were found to have an intussusception involving the small intestine (16 cases) or caecum (11 cases). The clinical signs, operative findings and techniques adopted to overcome the obstruction are described. An evaluation of possible predisposing factors provided further evidence of the important role of the tapeworm Anoplocephala perfoliata in initiating intussusception involving the ileum and caecum.
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PMID:Surgical management of intussusception in the horse. 375 12

Seventy-four patients with intractable constipation, of whom thirty-three had slow and forty-one normal intestinal transit, were investigated to determine the aetiology of their disorder and plan treatment. Patients with slow transit had a greater incidence of abdominal pain and distension (P less than 0.001) and only 9 per cent had a normal call to stool compared with 71 per cent of those with normal transit (P less than 0.001). Internal and sphincter function as assessed by sphincter pressures, length and the recto-anal inhibitory reflex did not reveal any difference between the groups and normal controls; similarly anal sensation and rectal compliance were normal. However, those with normal transit had a higher threshold of rectal sensation than controls (P less than 0.05). Slow transit patients failed to show a postprandial increase in rectosigmoid motility compared with controls (P less than 0.05). Whilst the majority failed to inhibit the external sphincter on bearing down, half of those with normal transit produced either partial or complete inhibition. Both groups were able to increase the anorectal angle on straining. Twenty-two normal transit patients had abnormal perineal descent compared with controls (P less than 0.0005). Patients with perineal descent exhibited abnormal rectal morphology. Rectal intussusception was observed in 13 of 35 evacuation proctograms. On the basis of the data presented, we could not justify internal sphincterotomy of puborectalis division. Our policy in severe slow transit constipation was to offer colectomy and ileorectal anastomosis. In five out of seven to date, a successful result has been achieved. Eight patients with rectal intussusception have undergone an abdominal rectopexy with significant improvement in three. In our hands, the evacuation proctogram and transit studies were the most useful preoperative investigations.
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PMID:Diagnosis and surgical management of intractable constipation. 376 60


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