Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Prompted by the case history of a 17 year old girl with anaemia, mononucleosis infectiosa and abdominal pain, paroxysmal nocturnal haemoglobinuria (PNH) is described. After a mononucleosis infectiosa infection she developed many complications of which the most prominent were hemolysis and thrombosis. Severe abdominal pain and episodic bowel obstruction occurred as a result of micro-infarction of the mesentery; bone marrow aplasia and lysis of platelets resulted in progressive thrombopenia. Pathogenesis and therapeutical possibilities are discussed. Coexistence of a necrotising enterocolitis with rectovaginal fistula, a heart infarction and the striking weight loss and hyponatremia during exacerbations, as seen in our patient, have not previously been described in PNH.
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PMID:[An adolescent with paroxysmal nocturnal hemoglobinuria]. 317 15

The case is reported of a young male who presented with massive anterior myocardial infarction after sniffing cocaine. The cardiovascular complications of cocaine abuse are numerous (sudden death, arrhythmia, myocardial infarction, myocarditis) and are being reported more and more frequently in the literature. Thoracic or abdominal pain in any patient known to abuse cocaine should be thoroughly investigated, despite the youth of these patients.
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PMID:[Myocardial infarct following cocaine abuse]. 318 82

A 44-year-old man died suddenly, shortly after admission to the hospital with complaints of abdominal pain. Medical history was significant for chronic alcoholism and homozygous hemoglobin C disease. Autopsy revealed vegetations on the aortic valve, especially on the left coronary cusp. There was anomalous origin of the coronary arteries from the left sinus of Valsalva. The large vegetation on the left coronary cusp had extended into the left main-stem coronary artery and obstructed it. There was evidence of prior embolization to the right coronary artery with mycotic aneurysm formation and myocardial infarction. Other lesions included a cerebral artery mycotic aneurysm and metastatic abscesses within the myocardium and spleen. Although the aortic valve was free of underlying chronic pathology, the causative organism was Streptococcus viridans. This case illustrates several unusual, and, in some instances, unique findings in infective endocarditis.
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PMID:Sudden death due to left coronary artery occlusion in infective endocarditis. 341 44

Cholestyramine, colestipol, clofibrate, gemfibrozil, nicotinic acid (niacin), probucol, neomycin, and dextrothyroxine are the most commonly used drugs in the treatment of hyperlipoproteinaemic disorders. While adverse reaction data are available for all of them, definitive data regarding the frequency and severity of potential adverse effects from well-controlled trials using large numbers of patients (greater than 1000) are available only for cholestyramine, clofibrate, nicotinic acid and dextrothyroxine. In adult patients treated with cholestyramine, gastrointestinal complaints, especially constipation, abdominal pain and unpalatability are most frequently observed. Continued administration along with dietary manipulation (e.g. addition of dietary fibre) and/or stool softeners results in diminished complaints during long term therapy. Large doses of cholestyramine (greater than 32 g/day) may be associated with malabsorption of fat-soluble vitamins. Most significantly, osteomalacia and, on rare occasions, haemorrhagic diathesis are reported with cholestyramine impairment of vitamin D and vitamin K absorption, respectively. Paediatric patients have been reported to experience hyperchloraemic metabolic acidosis or gastrointestinal obstruction. Concurrent administration of acidic drugs may result in their reduced bioavailability. Serious adverse reactions to clofibrate will probably limit its role in the future. Of particular concern are ventricular arrhythmias, induction of cholelithiasis and cholecystitis, and the potential for promoting gastrointestinal malignancy which far outweigh the reported benefits in preventing new or recurrent myocardial infarction, cardiovascular death and overall death. Patients with renal disease are particularly prone to myositis, secondary to alterations in protein binding and impaired renal excretion of clofibrate. Drug interactions with coumarin anticoagulants and sulphonylurea compounds may produce bleeding episodes and hypoglycaemia, respectively. Nicotinic acid produces frequent adverse effects, but they are usually not serious, tend to decrease with time, and can be managed easily. Dermal and gastrointestinal reactions are most common. Truncal and facial flushing are reported in 90 to 100% of treated patients in large clinical trials. Significant elevations of liver enzymes, serum glucose, and serum uric acid are occasionally seen with nicotinic acid therapy. Liver enzyme elevations are more common in patients given large dosage increases over short periods of time, and in patients treated with sustained release formulations.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Adverse effects of hypolipidaemic drugs. 354 4

We analyzed clinical data from 195 patients (141 boys) with myocardial infarction complicating Kawasaki disease, collected from 74 major hospitals in Japan. The myocardial infarction usually occurred within the first year of illness, but 27.2% of the patients had myocardial infarction more than 1 year later. In 63% of the patients it occurred during sleep or at rest. The main symptoms of acute myocardial infarction were shock, unrest, vomiting, abdominal pain, and chest pain; chest pain was much more frequently recognized in the survivors and in older patients. The myocardial infarctions were asymptomatic in 37% of the patients. Twenty-two percent of the patients died during the first attack. Sixteen percent of the survivors of a first attack had a second attack. Forty-three percent of all survivors of the first or subsequent attack are doing well; however, others have some type of cardiac dysfunction, such as mitral regurgitation, decreased ejection fraction of the left ventricle, or left ventricular aneurysm. Coronary angiographic studies indicate that in most of the fatal cases there was obstruction either in the main left coronary artery or in both the main right coronary artery and the anterior descending artery. In survivors, one-vessel obstruction was frequently recognized, particularly in the right coronary artery.
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PMID:Myocardial infarction in Kawasaki disease: clinical analyses in 195 cases. 371 57

Two cases of superior mesenteric arterial embolism are presented. The diagnosis should be suspected when severe abdominal pain develops suddenly in a patient with a cardiac arrhythmia or a recent history of myocardial infarction. Further support for the diagnosis is given by the finding of a poor peripheral circulation and a paucity of abdominal physical signs. The value of arteriography is questionable except to distinguish between thrombosis and embolism. The importance of early laparotomy as a diagnostic and life-saving measure is emphasized.
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PMID:Recognition and management of embolism to the superior mesenteric artery. 443 89

In prospectively evaluating 100 cases of adolescents with chest pain (along with two control groups), 91 were found to have recurrent chest pain; fewer than 5 had a serious organic cause. Significantly higher school absenteeism occurred in patients with either chest or abdominal pain than in patients without pain. Adolescents with chest and abdominal pain were more likely to be high users of medical services than those with no pain. Most adolescents believed that persons their age could have attacks; 44 of those with chest pain thought their symptom was due to a heart attack. The occurrence of chest pain was not influenced by an adolescent's age, sex, race, smoking status or family structure, nor was it consistently associated with depression. Chest pain is thus a common problem of adolescence that produces considerable functional impairment not attributable to serious underlying disease.
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PMID:Chest pain in adolescents--functional consequences. 650 73

In this community hospital medical center, all patients undergoing laparoscopic cholecystectomy (LC) who had a subsequent emergency room visit or hospital admission were reviewed to define the incidence and presentation of complications after hospital discharge. This unselected population, which is isolated geographically, provides a useful approximation of mortality and morbidity after hospital discharge. Of 1231 patients, 800 (65%) had no subsequent hospitalization or emergency room visit within a 6-32-month follow-up, whereas 431 (35%) did. Fifty-six (4.6%) patients had surgical complications related to their LC. The most serious complications were myocardial infarction (n = 1, the only death), common duct stricture (n = 2), retained common duct stone (n = 2), cystic duct leak (n = 2), subhepatic fluid collection or abscess (n = 3), pancreatitis (n = 3), and pulmonary (n = 5). Abdominal pain was the most common presenting symptom (62%), and 72% (42/56) occurred within 14 days, whereas, only 4% (15/375) patients with nonsurgically related complications presented within 14 days. In this study, emergency room visits and hospitalizations after LC occurred more commonly (35%) than generally appreciated, were usually minor, and were not related to the operative procedure, but serious late surgical complications occasionally appeared weeks to months postoperatively.
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PMID:Complications of laparoscopic cholecystectomy after hospital discharge. 761 45

A 28-year-old man with a history of rheumatic heart disease, alcoholism and amphetamine abuse presented with severe left upper quadrant abdominal pain and persistent fever. He stayed at home for the previous two months due to intermittent dull lower abdominal pain, chills, fever and tarry stools without seeking medical help. A diagnosis of infective endocarditis with splenic infarcts and a renal infarct was made based on the echocardiographic and abdominal computer tomography scan findings. His clinical course was complicated by an acute inferior wall myocardial infarction and cerebral hemorrhage. Despite aggressive medical treatment, his condition deteriorated. One month later, his condition became more critical with pneumonia and intractable shock, and his family requested his discharge. He died soon after leaving the hospital.
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PMID:Widespread embolism in a patient with infective endocarditis--a case report. 776 62

Clinical differentiation between acute myocardial infarction and peptic ulcer perforation may sometimes be difficult. We report on a sixty-five year-old patient who presented at the Emergency Department with upper abdominal pain and local tenderness suggestive of acute perforation of a gastric ulcer. However, the initial electrocardiogram (ECG) showed acute inferior wall myocardial infarction. Although abdominal pain is a major symptom of acute inferior wall myocardial infarction the history of gastritis and abdominal findings on admission of our patient required further exploration. The first plain abdominal radiograph was inconspicuous, therefore we performed a gastroscopy, which showed a prepyloric gastric ulcer. The second plain abdominal radiograph revealed air in the peritoneal cavity as sign of perforation. Echocardiography, ECG and the increase of heart enzymes confirmed acute inferior wall infarction. After successful surgical treatment of the perforated ulcer the patient recovered and progressed satisfactorily at the intensive care unit. He was discharged after three weeks and remains in good health. This case shows that rapid diagnosis and good interdisciplinary therapeutic management prevented a fatal outcome of acute myocardial infarction and concomitant gastric ulcer perforation in an elderly patient.
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PMID:[Concomitant perforated ulcer and acute myocardial infarct--a diagnostic challenge in emergency medicine]. 781 Jan 50


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