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

Four patients developed miliary tuberculosis while undergoing chronic hemodialysis. Two patients had diabetes mellitus. Three of the four patients were hemodialyzed 18--24 months prior to the onset of symptoms. Signs and symptoms included prolonged fever, pleural effusion, pericarditis with pericardial effusion, abdominal pain, weight loss, and ascites. All patients were PPD negative and without historical or radiographic evidence of latent tuberculosis. Disseminated tuberculosis was proven at autopsy in three patients. M. tuberculosis was eventually recovered from pleural fluid and urine in the fourth patient. The immune deficiencies of chronic renal failure and diabetes mellitus are suspected predisposing factors to the development of miliary tuberculosis in these patients.
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PMID:Unusual presentation of tuberculosis in chronic hemodialysis patients. 89 Oct 49

Two hundred cases of amebic liver abscess diagnosed between 1989 and 1991 at the Kasturba Medical College, Manipal were analyzed in this retrospective study. The clinical features and investigation reports were studied and the treatment and its response were analyzed. Amebic liver abscess constituted 0.6% of total hospital admissions during the study period. The male to female ratio was 13:1 with the most common age group of presentation between the fourth and fifth decades of life. Abdominal pain was the most common symptom (92%) and hepatomegaly was observed in 94% of the cases. Ultrasonogram of the abdomen served as the most useful diagnostic aid. Right lobe abscess was observed in 87% of the cases. Abscess was single in 81.5% of cases. Abscess size of more than 4 cm was observed in 46.5% of the cases. Metronidazole and chloroquine were found to be effective in most cases. Aspiration was done in 35.5% of cases. The complications encountered in this study were pleural effusion (two cases), pneumonic consolidation (four cases), pericardial effusion (one case) and ascitis (two cases).
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PMID:Profile of amebic liver abscess. 134 Mar 5

The Authors describe a 53 year old patient, who, after suffering from asthma over the past 10 years, presented with abdominal pain, diarrhoea, dyspnea, petechias on lower limbs, and subsequently developed fever, polyneuritis, pericardial effusion and renal failure. Laboratory showed elevated IgE, presence of antinuclear antibodies to DNA, serum rheumatoid factor and peripheral eosinophilia. The clinical course was suggestive for systemic vasculitis; lung, skin biopsies and renal angiography confirmed this diagnosis: the association with asthma and eosinophilia fulfill the diagnosis of allergic angiitis and granulomatosis (Churg-Strauss syndrome).
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PMID:[Churg-Strauss vasculitis in a 53-year-old man]. 163 Jul 4

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

Four patients had pancreatitis associated with valproic acid therapy. Three patients received valproic acid at usual doses, and all were free of other symptoms of toxic reactions, with serum levels of valproic acid in the usual therapeutic range. Two patients underwent exploratory laparotomy prior to diagnosis. Complications included pseudocyst, pericardial effusion, laparotomy wound infection, and coagulopathy. All patients recovered with discontinuation of valproic acid therapy and enteral feeding and administration of intravenous fluids. After recovery, a valproic acid regimen was restarted uneventfully (in one patient). All were asymptomatic with normal serum amylase levels after five to 14 months. Pancreatitis is a serious complication of valproic acid therapy that must be considered in any patient receiving valproic acid who experiences severe abdominal pain and vomiting.
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PMID:Pancreatitis associated with valproic acid therapy. 620 16

A 35-year-old man developed weight loss, lower abdominal pain, diarrhoea, cough, fever and general deterioration in his health. He had been born and resident in the USA until 1991, when he moved to Germany. Since 1991 he had known that he was HIV-positive. The chest radiograph showed bilateral diffuse spotty marking and a rounded cardiac silhouette, the latter echocardiographically due to pericardial effusion. Tuberculostatic drugs were started because miliary tuberculosis was suspected. But as his condition worsened and he was thought to have Pneumocystis pneumonia high doses of co-trimoxazole were administered. Perbronchial lung biopsy showed nonspecific chronic inflammatory changes. Periodide acid-Schiff reaction and Grocott staining demonstrated numerous histoplasma in alveolar macrophages and connective tissue. The organism was also cultured from bronchial secretions. Treatment was now changed to itraconazole (400 mg daily), 2 weeks later changed to liposomal amphotericin B (100 mg daily) because of renewed fever. After 6 weeks the patient became free of symptoms and the radiological changes had largely regressed. To prevent recurrence, treatment with itraconazole (400 mg daily) is being continued.
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PMID:[HIV-associated histoplasmosis with pulmonary manifestation in Europe]. 802 Mar 89

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

The authors report on a 7-year-old boy who suffered an unintentional penetrating cardiac injury while misusing a lawn toy in a predictable way. The boy was hemodynamically stable, with abdominal pain and tenderness. The pericardial effusion was first noted on upper abdominal computerized tomographic images and was confirmed by echocardiography. A puncture wound of the anterior right ventricle was found. As in this case, children may not have the typical signs and symptoms of cardiac tamponade, making the diagnosis difficult and delaying appropriate care. This child's injury could have been prevented through increased parental supervision or a modified toy design that takes into account predictable patterns of misuse.
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PMID:An unusual cause of penetrating cardiac injury in a child. 886 87

A 57 year-old woman was seen after a three-week period of upper abdominal pain, nausea, fever, headache and exertional dyspnoea. Laboratory examination showed an elevated ESR and serum gamma-GT activity. The chest X-ray showed cardiomegaly resulting from a pericardial effusion as was demonstrated by echocardiography. An abdominal CT-scan disclosed multiple hypodense lesions in the liver and spleen and lymphadenopathy along the hepatoduodenal ligament. Liver biopsy showed a necrotising granulomatous hepatitis. A recent infection with Bartonella, presumably B. henselae, was demonstrated serologically. The patient was treated with clarithromycin and recovered.
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PMID:[Visceral granulomas and pericardial effusion caused by a Bartonella henselae infection]. 915

This report describes the case of a young woman who presented to an emergency department with severe abdominal pain and shock. The patient was found to have pericardial tamponade due to a massive pericardial effusion. On further evaluation, the etiology of this effusion was considered to be secondary to hypothyroidism with concominant acute viral pericarditis leading to a fulminant tamponade. The presentation, differential diagnosis, and management of pericardial effusion and tamponade secondary to hypothyroidism and viral pericarditis are discussed. The diagnosis of hypothyroidism in conjunction with acute viral pericarditis should be considered in patients presenting with unexplained pericardial effusion and tamponade.
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PMID:Hypothyroidism presenting as acute cardiac tamponade with viral pericarditis. 1010 22


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