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

We report 6 patients with Munchausen syndrome, a fictitious disorder with physical symptoms. There were 4 females and 2 males, the age ranged from 21 to 29 years. Abdominal pain (2), hemoptysis, shock and hypoglycemia were the presenting symptoms. The diagnosis was made after a prolonged and costly hospital course, including invasive and non invasive diagnostic procedures. Two patients were ill enough to be at risk of death. An early diagnosis may help prevent unnecessary or risky procedures in these patients.
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PMID:[Munchausen's syndrome: a study of 6 cases]. 215 25

Chronic intestinal pseudo-obstruction is a clinical diagnosis based on signs and symptoms of bowel obstruction in the absence of a physical obstruction demonstrable by X-ray or surgery. The phenotype may be caused by gastrointestinal motor, sensory, or psychological disturbances, or even by Munchausen's syndrome-by-proxy. Interactions between these pathophysiologic mechanisms may result in changes in the clinical presentation during development, including an increase in the number of affected children complaining of chronic abdominal pain. Chronic pain or the fear of pain may cause children to limit their voluntary oral intake, necessitating tube or parenteral supplements. A multidisciplinary team approach which includes input from the pediatric gastroenterologist, pain management specialist, and psychologist is most likely to effect positive change. In considering a diagnosis of chronic intestinal pseudo-obstruction, the clinician is obligated to evaluate gastrointestinal motility and sensory function, as well as the behavior of the child and family. This review aims to provide a biopsychosocial conceptual framework for understanding the heterogeneous group of gastrointestinal neuromuscular conditions that are diagnosed as chronic intestinal pseudo-obstruction. It will also provide a review and critique of the utility of new diagnostic methods, including antroduodenal and colonic manometry, and new therapeutic options, including the prokinetic agents such as cisapride which increase motility, and intestinal transplantation.
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PMID:Chronic intestinal pseudo-obstruction in childhood: progress in diagnosis and treatment. 857 42

Factitious disorders may trouble any physician during his/her career. A considerable number of cases of Munchausen's syndrome (self-induced disorder) are misdiagnosed in clinical practice. A 36-year-old woman was admitted to our hospital because of fever and abdominal pain. Physical examination showed signs of inflammation of the abdominal wall, and histological examination revealed severe panniculitis. We investigated various aetiologic factors that could probably be related to fat necrosis, but we found no explanation of the phenomenon until we verified the diagnosis of Munchausen's syndrome. 2 years later, the patient underwent surgery for removal of needles, which she herself had deliberately located under her skin. High index of suspicion and physician's persistence are necessary to make the correct diagnosis in the various protean manifestations of Munchausen's syndrome.
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PMID:Munchausen's syndrome presenting as severe panniculitis. 1585 72

A 30-year-old nurse presented with abdominal pain and tenderness. Her blood tests, including amylase, were normal. Urinary amylase was extremely high. The source of the increased urinary amylase was found to be the patient's saliva - she had spit into her urine sample. Subsequent investigation showed that she had Munchausen's syndrome.
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PMID:Factitious hyperamylasuria by a nurse: symptom of Munchausen's syndrome. 1718 26

Munchausen syndrome is a rare psychiatric disorder in which patients inflict on themselves an illness or injury for the primary purpose of assuming the sick role. Because these patients can present with many different complaints and clinical symptoms, diagnosis is often made at a later stage of hospitalisation. In contrast we report a case of a 40-year old woman very easy to diagnose with Munchausen syndrome.This trained nurse presented at our emergency department (ED) complaining of abdominal pain. Interviewed by the medical trainee, she immediately confessed having put a knitting needle into her urethra four days earlier. She was not able to remove it anymore because it was beyond her reach. Abdominal X-ray confirmed the presence of the needle and a median laparotomy was performed to remove it. The diagnosis of Munchausen syndrome seemed immediately obvious in this case.
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PMID:Munchausen syndrome in the emergency department mostly difficult, sometimes easy to diagnose: a case report and review of the literature. 1990 8

A 30-year-old nurse presented with abdominal pain and tenderness. Her blood tests, including amylase, were normal. Urinary amylase was extremely high. The source of the increased urinary amylase was found to be the patient's saliva-she had spat into her urine sample. Subsequent investigation showed that she had Munchausen syndrome.
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PMID:Factitious hyperamylasuria by a nurse: a symptom of Munchausen syndrome. 2168 70

Factitious disorders are characterized by physical or psychological symptoms that are intentionally produced or feigned in order to assume the sick role. "Munchausen's syndrome" is one of these disorders and often is under-recognized or only suspected after unnecessary investigations. We report the case of a 15-year-old boy who came to our notice because of reduced urine output and recurrent abdominal pain during the previous 3 months. The patient attended several emergency room visits and he had been hospitalized for 1 month in an adult internal medicine department because of "oliguria". He had undergone several invasive investigations with normal results before the diagnosis of Munchausen's syndrome was made. General pediatricians and practitioners should be aware that suspecting Munchausen's syndrome in the first instance in the management of a patient showing discrepancies between reported urinary symptoms and the detectable clinical signs could avoid unnecessary and invasive exams.
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PMID:From oliguria to urinary incontinence: a case of Munchausen's syndrome in an adolescent boy. 2750 55