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)

Upper gastrointestinal bleeding occurred in a 64-year-old woman who was being treated with 1,000 mg acetylsalicylic acid and three times 5,000 IU heparin daily previous to a planned embolectomy because of occlusion of a lower leg artery. Radiology demonstrated multiple areas of osteolysis of the left thorax which were interpreted as recurrence of carcinoma of the breast, treated by mastectomy and radiotherapy 15 years previously. Acute renal failure, recurring severe back and abdominal pain, paraplegia of both legs and finally death from circulatory failure were explained as having been caused by multiple embolisation in the course of arteriosclerosis or a paraneoplastic increase in clotting activity. Autopsy revealed complete occlusion of the descending thoracic aorta by a malignant fibrous histiocytoma which had been the site of multiple emboli of thrombotic material and tumour tissue to spleen, kidneys, liver, intestinal segments, spinal cord and the artery to the left lower leg. Adrenal metastasis and osteolysis of the ribs were due to the histiocytoma and not the previously known carcinoma of the breast.
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PMID:[Malignant fibrous histiocytoma of the aorta]. 131 Apr 62

We present an interesting case of paroxysmal hypertension in a young male caused by malignant pheochromocytoma. This patient, who had history of paroxysms of abdominal pain with severe hypertension, developed osseous metastasis in the first lumbar vertebra resulting in collapse of the vertebra and it caused paraplegia. The diagnosis of pheochromocytoma was confirmed on histopathology.
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PMID:Malignant pheochromocytoma. 156 60

A 67-year-old woman developed a transient paraplegia as the initial manifestation of acute aortic dissection. Chest or abdominal pain was not present. Magnetic resonance imaging of the thorax demonstrated dissection of the aortic root, aortic arch, and descending aorta as well as pericardial effusion. Ultrasonography of the abdomen revealed an intimal flap in the region of the artery of Adamkiewicz. During aortic dissection, temporary obstruction of spinal arteries may result in transient paraplegia. Painless aortic dissection should be considered in patients who present with transient myelopathy.
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PMID:Painless aortic dissection presenting as spinal cord ischemia. 329 85

To determine the difference in the bowel care of spinal cord injury patients before and after enterostomy, we interviewed 20 patients--19 men and one woman. Their ages were 27-75, median 55 years. The paralytic lesions were spastic in ten and flaccid in ten. A total of 24 enterostomies were done for the following reasons: fecal contamination of decubitus ulcer in seven, colonic tumor in six, perforation of the colon in four, prolapse of the large intestine in four, inconvenience of bowel care in two, and perirectal abscess in one. There were 17 sigmoid and five transverse colostomies, and two ileostomies. (Two patients accounted for six procedures.) Follow-up time ranged from three months to six years, median nine months. Bowel care time was reduced from 0.7-14 hours, median 6.0 hours per week preoperatively, to 0.3-7 hours, median 1.0 hours per week postoperatively. Reversal of fecal leakage, abdominal pain, gas and anorexia were also reported. All patients were happier with their bowel care after surgery. We conclude that enterostomy in the spinal cord injury patient makes bowel care considerably more convenient, and improves the quality of life as well.
J Am Paraplegia Soc
PMID:Effect of enterostomy on quality of life in spinal cord injury patients. 374 92

Abdominal aortic aneurysm is a condition affecting nearly 4% of the elderly population. It has a potential for producing a wide range of symptoms, including abdominal pain and back pain. The latter is particularly difficult to interpret in patients with chronic rheumatological conditions, and delayed diagnosis may be associated with a poor outcome. We present a patient with rheumatoid arthritis and chronic low back pain, who developed bilateral leg weakness and hesitancy of micturition, due to an abdominal aortic aneurysm invading the spine.
Paraplegia 1995 Aug
PMID:Direct erosion of lumbar spine by an abdominal aortic aneurysm, resulting in paraparesis: unusual presentation. Case report. 747 45

We report 3 cases of dorsal ischemic myelopathy indicative of aneurysm of the abdominal aorta. In 2 cases the aneurysm was dissecting and in all patients medullary symptoms were preceded by sudden lumbar or abdominal pain. Neurological symptoms were slightly different in each case. One patient experienced 3 episodes of acute paraparesis and rapid regression evoking transitory medullary ischemic accidents (intermittent medullary claudication). Another patient suffered progressive asymmetric paraparesis which first stabilized and later improved partially after surgical treatment of the aneurysm. The third suffered acute paraplegia related to irreversible ischemia of the anterior 2/3 of the medulla. The great variety of clinical manifestations of spinal cord ischemia related to aneurysms of the descending aorta can be explained by the topography of the aneurysm, pecularities of medullary vascularization and, especially, by the diversity of etiopathogenetic mechanisms that give rise to ischemia. We conclude that in the face of symptoms suggesting dorsal ischemic myelopathy, the possibility that an aneurysm of the abdominal aorta may be the cause must be considered, whether or not pain has been experienced prior to signs of medullary involvement.
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PMID:[Spinal cord ischemia indicating aneurysm of the abdominal aorta. Report of three cases]. 761 38

Intravesical oxybutynin hydrochloride was administered to 17 patients with a neuropathic bladder (myelomeningocele in 15 and spinal cord tumour in two) and urinary incontinence refractory to intermittent catheterisation. Therapy consisted of instillation of a 10 ml solution containing 5 mg oxybutynin hydrochloride twice daily. The cystometric bladder capacity before and after 1 hour of intravesical oxybutynin hydrochloride was 132 +/- 45 ml and 193 +/- 71 ml (mean +/- 1 standard deviation, p < 0.01) in all 17 patients. In 13 patients with low compliant bladders, the mean bladder compliance before and after 1 hour of instillation was 4.2 +/- 2.4 ml/cmH2O and 8.5 +/- 6.4 ml/cmH2O respectively (p < 0.01). The period of the intravesical oxybutynin hydrochloride treatment ranged from 2 to 16 months (mean 11.1 months). The improvement rate of 'moderately improved' and better response was 76.5% in all 17 patients. One patient complained of slight lower abdominal pain, which receded as treatment continued. Since the pH value of the solution appeared to be so low as to irritate the vesical mucosa, the value was adjusted to 5.85. No local or systemic side effects were observed thereafter. These encouraging results suggest that intravesical instillation of oxybutynin hydrochloride is an attractive alternative in patients with a neuropathic bladder, who are either unresponsive to or have intolerable side effects from oral medications.
Paraplegia 1994 Jan
PMID:Intravesical instillation of oxybutynin hydrochloride therapy for patients with a neuropathic bladder. 801 32

Injuries to the abdominal aorta as a result of blunt trauma in children are extremely rare. We encountered one such injury and a review of the literature revealed seven additional cases. Lower extremity ischemia, abdominal bruit, or paraplegia may suggest that diagnosis at the time of injury. Delayed presentations are characterized by abdominal pain or a pulsatile mass, with or without bruit. A high index of suspicion with early aortography is indicated to diagnose blunt aortic trauma.
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PMID:Blunt abdominal aortic trauma in children: case report. 845 74

The coeliac plexus block is an approved method for the relief of upper abdominal pain due to cancer of the upper intra-abdominal viscera or to chronic pancreatitis. While there are many reports concerning the posterior approach to the coeliac plexus block, little attention has been given the anterior approach. There are two ways of implementing the anterior approach to the coeliac plexus: CT-guided and the ultrasound guided approach. METHODS. The ultrasonic-guided anterior approach to the coeliac plexus block is used with the patient in the supine position. The aorta and discharge of the truncus coeliacus or the a. lienalis respectively, are ultrasonographically presented at two levels. After setting local cutaneous and subcutaneous anaesthesia, a 15-cm-long 25 G-needle is introduced into the epigastrium. The point of the needle is--ultrasonographically guided--inserted into the pre-aortic area near the discharge of the truncus coeliacus. The position of the needle point is ultrasonographically controlled on two levels. For the enforcement of a diagnostic coeliac plexus block after careful aspiration on two levels, 10 ml of bupivacaine 0.5% is injected. The spread of the solution is evaluated by ultrasound. If the needle position is correct; a few minutes later the patient has a feeling of warmth in the upper abdominal region. For the enforcement of a neurolytic coeliac plexus block 10 ml ethanol 96% and 10 ml prilocaine 1% can be administered. The two solutions are applied as small volumes in permanent succession. Thus the burning pain, which is often observed after the injection of alcohol, is avoided. RESULTS. In the literature there are only a few reports, about the results and side-effects after use of the anterior approach in the coeliac plexus block. The results of these investigations and our own show total pain relief or at least good pain reduction by at best 85%. The reduction in pain achieved continues in as many as 60% of the treated patients. There is the possibility to stop or at least reduce the analgesic premedication. These results are comparable with those after using the posterior approach to the coeliac plexus block. When carrying out the anterior approach in the coeliac plexus block, most of the patients showed increased intestinal motility. Therefore, about 60% of all patients had transitory diarrhoea. In 12-25% of the patients orthostatic hypotension was observed. This side-effect is avoided by an appropriate infusion before enforcement of the block. In a frequency of 4-100% the occurrence of burning pain was reported during injection of the alcohol. No serious side-effects were observed. CONCLUSIONS. The results concerning total pain relief or at least pain reduction are comparable to the posterior approach for the block. Nevertheless, there are some advantages to the ultrasound-guided anterior approach. There is less risk using this technique. No methodological complications have been observed so far. There is no risk of neurological complications such as paraplegia. Because the patients remain in the supine position, the anterior approach to the coeliac plexus block is suitable for terminally ill patients, who are not able to tolerate the prone position and need careful supervision and good ventilation. Also, no contrast medium is necessary. Only a small volume of local anaesthetics or alcohol is required. We prefer the anterior approach of the coeliac plexus block as a fast, safe and cost-effective method, which should receive increasing attention during the next few years.
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PMID:[The anterior sonographic-guided celiac plexus blockade. Review and personal observations]. 848 98

To assess the feasibility of treatments for patients with small cell lung cancer (SCLC) showing a poor performance status (PS, Eastern Cooperative Oncology Group; ECOG 3 or 4), we retrospectively reviewed the outcome for 13 SCLC patients showing poor PS treated at the National Cancer Center Hospital between January 1984 and May 1994. The main factors which contributed to poor prognosis were superior vena cava (SVC) syndrome, massive pleural effusion, tracheal stenosis due to lymph node swelling, pericardial effusion and pulmonary fibrosis (causing dyspnea in combination), brain metastasis resulting in neurological disturbance, cachexia, Eaton-Lambert syndrome causing muscle weakness, retroperitoneal lymph node metastasis causing abdominal pain, peritoneal effusion due to abdominal lymph node swelling, vertebral metastasis causing paraplegia, and dermatomyositis/polymyositis (DM/PM) causing muscle weakness. All of the patients received chemotherapy with or without radiotherapy. The PS of 8 patients improved with treatment, but no improvement was seen in 5. We analyzed these 13 patients and considered the treatments for those with poor PS. Chemo-radiotherapy was tolerable in SCLC patients showing PS 3, and improved their PS if severe conditions or combined disease did not arise concurrently. It was further suggested that PS 4 patients with severe conditions or combined disease should not be given the treatments.
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PMID:Retrospective analysis of the treatment of patients with small cell lung cancer showing poor performance status. 865 51


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