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

Ischemic colitis is typically limited to elderly patients who have concomitant disorders such as cardiovascular disease and chronic renal failure, but rarely affects a young person. The patient was an 18-year-old Japanese female who started dieting to obtain a slim figure three months before admission and presented with a two-month history of constipation and a sudden onset of lower abdominal pain and bloody diarrhea. She underwent colonoscopy, which revealed edema, hemorrhages, and several longitudinal shallow ulcers in the descending colon. Stool and blood culture results were negative for pathogens. She improved rapidly within five days without any specific therapies except intravenous hydration and anticholinergic agents, under the diagnosis of ischemic colitis. In this case constipation and dehydration associated with dieting seemed to be responsible for the development of ischemic colitis. We recommend that ischemic colitis should be included in the differential diagnosis of colitis with bleeding, even in patients younger than age 20 who do not have any predisposing factors.
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PMID:Ischemic colitis caused by strict dieting in an 18-year-old female: report of a case. 1206 8

A 67-year-old man was admitted with abdominal pain on April 23, 2000. Continuous ambulatory peritoneal dialysis (CAPD)-related peritonitis was diagnosed. Administration of antibiotics for five days obtained no improvement. Therefore the peritoneal catheter was removed on April 28th. Although his condition became settled, C-reactive protein remained positive. Moreover, two kinds of bacilli were detected from the CAPD fluid, just before the catheter was removed. As abnormalities in the colon were possible, an enema examination was performed on May 23rd. A constriction and several diverticula of the sigmoid colon were detected. High grade fever appeared on May 23rd, and the patient complained of abdominal pain the next day. As there was no improvement, we performed enhanced computed tomography and detected an abscess in the Douglas pouch on May 29th. The abscess was resected on the same day, and he was discharged. The number of patients with chronic renal failure has increased in recent years. Although hemodialysis has been the treatment of choice, peritoneal dialysis should be considered. More investigations into complications created by peritoneal dialysis are required, especially in elderly people who seldom show symptoms of CAPD-related peritonitis until they reach a critical condition. If peritoneal dialysis is being performed and inflammation reactions continue, it is necessary to examine the patient for perforated peritonitis and abscess formation.
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PMID:[A rare case illustrating the difficulty of diagnosing and treating elderly patient with CAPD-related peritonitis caused by the perforation of sigmoid colon diverticulum]. 1207 95

We report a 31-year-old man with chronic renal failure and ascites who developed severe abdominal pain and a local non-pulsatile mass after therapeutic paracentesis. Doppler study confirmed a pseudoaneurysm of the right inferior epigastric artery. The patient recovered after the artery was ligated and the aneurysm excised.
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PMID:Pseudoaneurysm of inferior epigastric artery following abdominal paracentesis. 1241 51

Familial Mediterranean fever (MFF) is an autosomic recessive, inherited inflammatory disease principally seen in persons from the Mediterranean area. Clinical findings include fever, abdominal pain, and pleuritis. The most severe complication of MFF is renal amyloidosis, manifested as nephrotic syndrome, which evolves into chronic renal failure. In this study, we described clinical findings, evolution, and response to treatment in 52 patients diagnosed with MFF living in Mexico City in whom the most important clinical features were fever and abdominal pain. Differing from previous reported series of patients from the Mediterranean area, patient developed renal amyloidosis during the 20-year follow-up, which suggests that an environmental factor might have a significant influence in development of renal amyloidosis.
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PMID:[Familial Mediterranean fever in Mexico City. A 20-year follow-up]. 1517 32

Eosinophilic peritonitis is defined as when there are more than 100 eosinophils present per milliliter of peritoneal effluent, of which eosinophils constitute more than 10% of its total WBC count. Most cases occur within the first 4 weeks of peritoneal catheter insertion and they usually have a benign and self-limited course. We report a patient of eosinophilic peritonitis that was successfully resolved without special treatment. An 84-year-old man with end stage renal disease secondary to diabetic nephropathy was admitted for dyspnea and poor oral intake. Allergic history was negative. and physical examination was unremarkable. Complete blood count showed a hemoglobin level of 11.1 g/dL, WBC count was 24,500/mm3 (neutrophil, 93%; lymphocyte, 5%; monocyte, 2%), platelet count was 216,000/mm3, serum BUN was 143 mg/dL, Cr was 5.7 mg/dL and albumin was 3.5 g/dL. Creatinine clearance was 5.4 mL/min. Three weeks after peritoneal catheter insertion, he was started on peritoneal dialysis with a 6-hour exchange of 2L 1.5% peritoneal dialysate. After nine days, he developed turbid peritoneal effluents with fever (38.4 degrees C), abdominal pain and tenderness. Dialysate WBC count was 180/mm3 (neutrophil, 20%; lymphocyte, 4%; eosinophil, 76% [eosinophil count: 136/mm3]). Cultures of peritoneal fluid showed no growth of aerobic or anaerobic bacteria, or of fungus. Continuous ambulatory peritoneal dialysis (CAPD) was commenced, and he was started on intraperitoneal ceftazidime (1.0 g/day) and cefazolin (1.0 g/day). After two weeksr, the dialysate had cleared up and clinical symptoms were improved. Dialysate WBC count decreased to 8/mm3 and eosinophils were not detected in peritoneal fluid. There was no recurrence of eosinophilic peritonitis on follow-up evaluation, but he died of sepsis and pneumonia fifteen weeks after admission.
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PMID:Eosinophilic peritonitis in a patient with continuous ambulatory peritoneal dialysis (CAPD). 1536 44

We identified 40 pediatric patients with urolithiasis. There were 27 boys and 13 girls. Initial symptoms were abdominal pain, with or without microscopic hematuria in 40% of the cases, and urinary tract infection/pyelonephritis in 25% of the cases. Stones were made of struvite (35% of the cases), calcium-phosphate (25%) or calcium-oxalate (20%). The high prevalence of struvite stones reflects the importance of urinary tract infection a major cause of urolithiasis in that specific age group. Hypercalciuria was the most common urinary biochemical abnormality, found in more than 50% of the children. In the absence of a spontaneous passage of the stone, extra-corporeal shock wave lithotripsy represents an excellent therapeutic option. This article emphasizes the importance of stone analysis and extensive biochemical investigations in children with urolithiasis, in order to avoid recurrence and potential progression towards chronic renal failure.
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PMID:[Urinary calculi epidemiology in children]. 1549 64

It is possible to identify renal cysts in several subjects by ultrasonography imaging techniques. Among the inherited polycystic kidney diseases we include autosomal recessive polycystic kidney disease (ARPKD) and autosomal dominant polycystic diseases such as von Hippel-Lindau disease, tuberous sclerosis complex (TSC1 and TSC2), and autosomal dominant polycystic kidney disease (ADPKD). ARPKD is a rare disease, related to PKHD1 gene, located on chromosome 6p21, that encodes a protein named polyductin/fibrocystin. Pathoanatomical features are bilateral kidney involvement with multiple microcysts, and invariably liver involvement with portal and interlobular fibrosis. A single genetic defect leads to different degrees of renal and hepatic involvement with very different phenotypes and different clinical outcome, in the same family too. ARPKD clinically may show 4 different forms: perinatal, neonatal, infantile, and juvenile. ADPKD is much more frequent (1: 400-1000 live births), and can arise from mutations in 2 different genes, named PKD1 located on chromosome 16p13.3, and PKD2 located on chromosome 4q21-23. The proteins encoded by the PKD1 and PKD2 genes are named polycystins which play crucial roles in several biologic processes. To explain the focal lesions that affected different organs and tissues the "double hit" theory has been proposed (germinal mutation plus somatic mutation on PKD1 or PKD2). Recently, biologic evidence documented the crucial role of the renal primary cilia on the formation of polycystins to induce cystogenesis. ADPKD may be clinically characterized by abdominal pain, hypertension, episodes of gross hematuria, headache, renal stones, aortic and cerebral aneurysms, mitral valve prolapse, and polycystic liver disease. ADPKD is slowly progressive disease responsible for up 10% of end stage renal failure (ESRF) in every country of the world. Male sex, PKD1 gene, episodes of gross hematuria, and the precocity and severity of hypertension play an important role in the progression of renal disease to ESRF.
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PMID:Autosomal recessive and dominant polycystic kidney diseases. 1578 25

Hepatic portal venous gas (HPVG) has been rarely described in chronic hemodialysis patients. We report a case of HPVG in a 59-year-old female patient with hemodialysis-dependent chronic renal failure due to diabetes who presented with acute onset of abdominal pain. Abdominal CT demonstrated the presence of gas in the portal veins. However, on laparotomy, no evidence of bowel necrosis or perforation could be found. HPVG seemed to be caused by nonocclusive mesenteric ischemia (NOMI), an increasingly recognized complication in hemodialysis patients. The patient responded favorably to intravenous hyperalimentation and antibiotics.
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PMID:Hepatic portal venous gas associated with nonocclusive mesenteric ischemia in a hemodialysis patient. 1584 60

A 49 year-old woman with chronic renal failure (CRF) on continuous ambulatory peritoneal dialysis (CAPD) because of Goodpasture Syndrome was admitted to our hospital since she had a high fever and severe abdominal pain. A diagnosis of peritonitis was made from the physical examination and laboratory findings. The peritonitis was refractory to conventional antibiotics therapy. Candida parapsilosis was detected from dialysite. The peritonitis was aggravated although the antibiotic was changed to an antifungal agent (fluconazole 400mg/day). Fluconazole was replaced to micafungin (MCFG) and the catheter for CAPD was removed. The fungal peritonitis improved dramatically and beta-D glucan was decreased from 104 to 12.6 (pg/ml). No adverse effect was observed after using MCFG. It has been known that fungal peritonitis of CRF patients is refractory to treatment and the mortality rate is high. To our best knowledge, there is no report that MCFG was used for CRF patients with fungal peritonitis. However, we used MCFG safely and effectively for CRF patients. Therefore, it is suggested that MCFG is a new effective and safe antifungal agent for Candida parapsilosis peritonitis with CRF.
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PMID:[Successful treatment with micafungin (MCFG) of severe peritonitis due to Candida parapsilosis with chronic renal failure patient on hemodialysis]. 1597 61

Autosomal-dominant polycystic kidney disease is an inherited disorder characterized by multiple cysts in kidneys and other organs. A 63-year-old man was evaluated for the etiology of recurrent pancreatitis and chronic renal failure. Multiple cysts of kidneys, liver, and pancreas and pancreas divisum was diagnosed. Pancreatitis should be included in the differential diagnosis of abdominal pain in patients with ADPKD. Pancreas divisum may be a predisposing factor for acute pancreatitis in these patients.
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PMID:Recurrent pancreatitis in a patient with autosomal-dominant polycystic kidney disease. 1635 65


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