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

Fifty-six consecutive patients presenting to one general surgical unit with acute upper abdominal pain were submitted to early diagnostic endoscopy after exclusion of perforation, pancreatitis and gallstone disease. Endoscopy was performed within 48 h of admission in 84% of patients and 68% of the study group were discharged within 48 h of the procedure. In 26 patients a definite causative pathology was identified. In 13 patients there were mucosal changes of doubtful significance, while in 17 patients the examination was normal. Endoscopy in patients admitting to excess alcohol intake was generally unrewarding and there was poor correlation between the clinical diagnosis of peptic ulcer and endoscopic findings. The clinical diagnosis was revised in 64% of patients following endoscopy. The data from this study suggest that early endoscopy in acute upper abdominal pain results in a high yield of positive findings, permits rapid correction of diagnostic errors and facilitates early institution of management and discharge.
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PMID:Evaluation of upper gastrointestinal endoscopy as a primary investigation in patients with acute upper abdominal pain. 234 20

As part of a survey on the work environment of bus drivers, 2045 (83%) of 2465 male bus drivers in the three major cities in Denmark in 1978 answered a postal questionnaire on health and working conditions. In order to evaluate the relative occurrence of peptic ulcer among the bus drivers, a follow-up study was also conducted. All hospital discharges with a peptic ulcer diagnosis among the bus drivers were registered from the Danish National Patient Register. All Danish men were used as reference group. On the basis of the 1978-questionnaire association between occupational and psychosocial factors and subsequent hospital discharge with a peptic ulcer diagnosis was studied. The prevalence of abdominal pain alleviated by food intake was 12% among bus drivers and 6% in the reference group. The incidence of hospital discharge with duodenal ulcer among younger bus drivers was twice the incidence among Danish men in the same age group. The incidence of all manifestations of peptic ulcer disease among bus drivers did not differ from the incidence among Danish men. Of occupational and psycho-social factors, wage dissatisfaction and smoking showed statistically significant association with hospital discharge with PU in a 6 3/4-year period. Job dissatisfaction, stress symptoms and lack of some social network factors tended to increase the risk of hospital discharge with PU.
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PMID:Peptic ulcer among urban bus drivers in Denmark. 236 27

Numerous reports have established the association of Helicobacter pylori and peptic ulcer disease in adults. Recently, this association has also been demonstrated in children. We investigated 14 children and adolescents with recurrent abdominal pain. In six patients, endoscopy revealed gastritis and Helicobacter pylori was identified. Giemsa stain was more sensitive than culture or urease testing in identifying the bacteria. In four of the six, a nodular appearance of the antral mucosa was observed. The histological examination suggests lymphoid hyperplasia as the cause of the nodularity. All of the patients became symptomless after combined treatment with amoxicillin and bismuth subsalicylate. We conclude that nodular gastritis is a peculiar type of gastritis in children. It is frequently found in association with Helicobacter pylori infection.
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PMID:Nodular gastritis and Helicobacter pylori. 205 Dec 85

In a retrospective survey, the clinical details of all children with primary peptic ulcer seen at Red Cross War Memorial Children's Hospital over a 12-year period were analysed. The diagnosis was confirmed in 31 cases, 22 of whom had a duodenal ulcer. Gastro-intestinal bleeding was the presenting symptom in 19 patients. In 7 of these there were no preceding symptoms, rendering earlier diagnosis impossible. Those presenting with abdominal pain had a mean interval of 2.8 years between onset of symptoms and diagnosis. Useful clinical clues in these children were epigastric tenderness and anaemia. To avoid diagnostic delays, peptic ulcer disease should be considered more often in children with abdominal pain. When available, gastro-intestinal tract endoscopy should be the diagnostic investigation of choice.
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PMID:Primary peptic ulcer disease in childhood. 240 5

This study was based upon deceased patients in a geriatric university hospital with a high autopsy rate (81%). Of 6200 autopsied patients, 333 (5.4%) had had an active peptic ulcer; agonal and other acute erosions were not included. 257 cases were selected for the study (average age 83.8 yr). The diagnostic accuracy, and the symptoms of peptic ulcer in stationary, elderly, chronically ill patients were studied retrospectively. Only 16% of cases with duodenal ulcer and 29% with gastric ulcer had been correctly diagnosed antemortem. The clinical features of ulcer disease in the elderly may often differ from the standard presentation in younger people. Prior to death, appetite and weight loss, nausea/vomiting, anaemia and positive occult blood test had been more common among patients with ulcer, than abdominal pain and heartburn. The predictive values of single symptoms and of combined findings were low (range 2-21%), thus supporting observations from clinical practice that diagnosis is difficult in geriatric medicine. Prospective studies of ulcer disease in living elderly are needed.
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PMID:Peptic ulcer in geriatric long-term care medicine. 248 4

Results of studies on the frequency of the occurrence of the bacteria, Campylobacter pylori, in the mucous membrane of the gastric antrum are presented in this paper. The study was carried out on 61 children treated for chronic abdominal pain. The diagnosis was established on the basis of flexible endoscopy and histology of antral biopsies. The presence of Campylobacter pylori was determined using the CLO-test. The positive CLO-test was obtained in 87.5% of children with gastritis, in 75% of children with duodenal ulcer and in only 17% of children from control group (p less than 0.001). Four-week therapy with De Nol eradicated Campylobacter pylori in 60% of treated children, and reduced infection in the next 25%. These bacteria seem to play an important role in the pathogenesis of chronic gastritis and peptic ulcer disease.
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PMID:Campylobacter pylori in upper digestive tract diseases in children. 248 38

To study the prevalence of dyspepsia in the community a postal questionnaire was sent to 2697 patients who were selected at random from the lists of patients registered in two health centres in Hampshire. A total of 2066 returned questionnaires were suitable for analysis (response rate 77%). It was found that the six month prevalence of dyspepsia was 38%. There was considerable overlap between symptoms of heartburn and upper abdominal pain, with over half of patients with dyspepsia experiencing both. One in four of these patients had consulted their general practitioner during that time. The proportion of patients with dyspepsia who consulted their general practitioner varied widely among the eight doctors who participated in the study, from 17% to 45%. Frequency of symptoms tended to fall with age, particularly in men, while the proportion of patients with dyspepsia who sought medical advice increased with age. Almost one in five of the 2066 patients had been investigated with radiology or endoscopy at some time, and 143 (7%) of them claimed to have had a diagnosis of peptic ulcer.
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PMID:Prevalence of symptoms of dyspepsia in the community. 249 49

Gangrene of the stomach is a rare, often fatal disease which may be due to vascular, chemical, mechanical, or infectious etiologies. The infectious type, acute necrotizing gastritis, is thought to be a variant of phlegmonous gastritis, which has been associated with recent large intake of alcohol, "gastritis," and upper respiratory tract infections. Our patient, who had a history of peptic ulcer disease and gastric outlet obstruction, presented with abdominal pain, hypotension, and pneumomediastinum.
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PMID:Acute necrotizing gastritis in a patient with peptic ulcer disease. 259 58

In an audit of 1190 emergency admissions with abdominal pain (1166 patients) in a general surgical unit, the diagnosis was non-specific abdominal pain (NSAP) in 415 (35 per cent), acute appendicitis in 200 (17 per cent) and intestinal obstruction in 176 (15 per cent). The largest number of admissions occurred in the age groups 10-29 years (31 per cent) and 60-79 years (29 per cent). Surgical operations were performed in 551 patients (47 per cent) and there was a 16 per cent incidence of unnecessary appendicectomy (22 per cent in the age group 20-29 years). Fifty-one deaths resulted in a 30-day hospital mortality rate of 4.4 per cent and a perioperative mortality rate of 8 per cent. The mortality rate increased significantly in patients aged greater than or equal to 60 years, and patients aged 80-89 years had a perioperative mortality rate of 20 per cent. The causes of perioperative death included laparotomy for inoperable disease (28 per cent), ruptured abdominal aortic aneurysm (23 per cent), perforated peptic ulcer (16 per cent) and colonic resections (14 per cent). The perioperative mortality rates for ruptured aneurysm and perforated ulcer were 71 and 23 per cent respectively. The duration of inpatient stay increased significantly with the age of the patients, including those with NSAP. The results of the study indicate a need to review the methods of management of ruptured aortic aneurysm and perforated peptic ulcer, the methods of diagnosis of appendicitis, particularly in young females, and the factors that determine the duration of stay of patients suffering from NSAP.
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PMID:Abdominal pain: a surgical audit of 1190 emergency admissions. 259 64

We report a review of 20 children (14 males and 6 females) between 3 1/2-13 years of age (mean 9.7/ 12 years) with primary peptic ulcer disease, diagnosed by digestive fiberendoscopy. Endoscopy revealed 18 duodenal and 2 gastric ulcers. Positive family history was found in 45% of the patients. Abdominal pain was the most common presenting symptom and gastrointestinal bleeding was the only complication. The time before diagnosis was lesser than one month in 10%, between one to six months in 30% and more than months in 60% of patients. The follow-up period rate from three to 46 months (mean 14.9/12 months). Radiological study was performed in 18 patients and led 50% of false negative. A satisfactory response to mean treatment was found in all cases. Three patients related No patients required surgical treatment.
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PMID:[Primary peptic ulcer in childhood: apropos of 20 cases studied using digestive fiberendoscopy]. 265 16


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