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

As the utilization of MRI in the assessment for paediatric appendicitis increases in clinical practice, it is important to recognize alternative diagnoses as the cause of abdominal pain. The purpose of this review is to share our institution's experience using MRI in the evaluation of 510 paediatric patients presenting with suspected appendicitis over a 30 month interval (July 2011 to December 2013). An alternative diagnosis was documented in 98/510 (19.2%) patients; adnexal pathology (6.3%, n = 32), enteritis-colitis (6.3%, n = 32), and mesenteric adenitis (2.2%, n = 11) comprised the majority of cases. These common entities and other less frequent illustrative cases obtained during our overall institutional experience with MRI for suspected appendicitis are reviewed.
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PMID:Alternative diagnoses at paediatric appendicitis MRI. 2607 83

Abdominal pain is very common in the pediatric population (<18 years of age). Sonography is a safe modality that can often differentiate the frequently encountered causes of abdominal pain in children. This pictorial essay will discuss the sonographic findings of acute appendicitis, including the imaging appearance of a perforated appendicitis. It will also present the sonographic features of the relatively common mimics of appendicitis, such as mesenteric adenitis/gastroenteritis, intussusception, Meckel diverticulum, and ovarian torsion.
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PMID:Sonography of Abdominal Pain in Children: Appendicitis and Its Common Mimics. 2689 21

Mesenteric lymphadenitis is a clinical condition that affects mostly children and teenagers. Its symptoms include fever, severe abdominal pain, nausea, and, in some cases, diarrhea, constipation, and acute abdomen. This paper describes the case of a 16-year-old patient with mesenteric lymphadenitis submitted to an exploratory laparoscopy for suppurative lymph nodes that evolved to a drastic reduction of ovarian reserve. Because of the patients age, she was offered cryopreservation of her ovarian tissue.
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PMID:Is mesenteric lymphadenitis a cause of ovarian reserve reduction? - Case Report. 2720 6

Detecting Whipple's disease, a "great imitator", requires a high index of suspicion so that antimicrobial treatment can be initiated in a timely manner; a missed diagnosis can be fatal. Although an uncommon cause, Whipple's disease must be considered in adults with mesenteric lymphadenitis. We report the case of a 39-year-old African American man who presented with chronic joint pain, chronic weight loss, and acute onset epigastric pain. Contrast-enhanced computed tomography of the abdomen and pelvis showed extensive mesenteric lymphadenopathy. A diagnosis of Whipple's disease was made based upon demonstration of PAS-positive macrophages in the mesenteric lymph node and duodenal biopsies. Antimicrobial therapy resulted in weight gain and resolution of abdominal pain and arthralgia at six months follow-up. Whipple's disease can be fatal without antibacterial therapy and it always needs to be considered in individuals presenting with any combination of abdominal pain, weight loss, and diarrhea in the background of nonspecific arthritis or arthralgia. Whipple's disease must also be considered in adults presenting with mesenteric lymphadenitis. Review of CT scans may be helpful, as Whipple's disease characteristically causes low attenuation mesenteric lymphadenopathy.
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PMID:Mesenteric lymphadenitis as a presenting feature of Whipple's disease. 2866 Jan 30

This report describes two cases of Salmonella mesenteric lymphadenitis leading to septic peritonitis in two young dogs. The cases were similar in presentation, diagnosis, treatment, and length of hospitalization. Both cases presented with clinical signs of vomiting, abdominal pain, and fever and were treated successfully via surgical debridement, omentalization, and antibiotic therapy. Both cases grew multi-drug resistant Salmonella spp. with resistance to ampicillin sulbactam, which is a common empiric antibiotic choice for cases of canine septic peritonitis. In both cases, the source of Salmonella is proposed to be the raw diet that preceded the septic peritonitis diagnosis. While Salmonella mesenteric lymphadenitis has been reported in humans and pigs, to the authors' knowledge, this is the first report of Salmonella mesenteric lymphadenitis in dogs.
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PMID:Salmonella Mesenteric Lymphadenitis Causing Septic Peritonitis in Two Dogs. 3216 15

The diagnostic uncertainty for children with abdominal pain has increased during the COVID-19 pandemic with the additional consideration of both COVID-19 and paediatric inflammatory multisystem syndrome-temporally associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (PIMS-TS) alongside appendicitis, mesenteric adenitis and other less common causes of abdominal pain. We describe the cases of two children who presented with severe abdominal pain, non-bilious vomiting and high temperatures during the UK's first peak of the COVID-19 pandemic. Laboratory and abdominal ultrasound features were similar for both children but symptom progression in combination with cross-sectional abdominal imaging enabled differentiation between PIMS-TS and appendicitis with concurrent COVID-19. These cases highlight the importance of regular clinical review, multidisciplinary working and the utility of early cross-sectional imaging to determine the underlying condition.
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PMID:Paediatric abdominal pain in the time of COVID-19: a new diagnostic dilemma. 3299 18


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