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

Two hundred and twenty-two patients with Peutz-Jeghers syndrome were ascertained in Japan between 1961 and 1974 through two nationwide surveys, medical literature, and personal examinations. Genetic analysis was made of this group as well as 102 follow-up cases. The average age at diagnosis was 23 in males and 26 in females, with male to female ratio of 1:1.13. Presenting complaints of 170 patients included obstruction (42.8 per cent of patients), abdominal pain (23.4 per cent), rectal bleeding (13.5 per cent), extrusion of polyp (7.2 percent). Diagnosis of 52 patients was based on melanin pigmentation. Intussusception occurred in 46.9 per cent of the patients, most often in the small intestine. Polyps occurred in the stomach in 108 patients (48.6 per cent), small intestine, 142 patients (64 per cent), colon, 118 patients (53.2 per cent) and rectum, 71 patients (32 per cent). Among the 222 patients, cancer was histologically verified in 28. Fifteen early cancers occurred (3 gastric, 8 small intestine, 4 colon), and 11 advanced cancers (3 gastric, 1 small intestine, 6 colon, and 1 both colon and small intestine). Mortality was lower than in patients with familial polyposis coli but higher than in the general population. Conservative surgical management, planned medical follow-up, and the need for a national registration system are stressed.
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PMID:Peutz-Jeghers syndrome: its natural course and management. 111 95

The immediate postoperative and long-term functional results of 51 ulcerative colitis patients and 21 familial polyposis patients who underwent ileal J-pouch-anal anastomosis were compared in this study. The incidence of postoperative complications requiring reoperation was not statistically different in both groups. The mean daily stool frequency was significantly higher in colitis patients. Pouchitis occurred in 44% of colitis patients but not in polyposis patients (P < 0.005). Symptoms of pouchitis included bloody diarrhea, urgency, abdominal pain, weight loss, fever, and arthritis. Six colitis patients required pouch excision because of intractable pouchitis. The overall pouch excision rate was 22% in ulcerative colitis patients and 5% in familial polyposis patients. Patient satisfaction was good in 46% of ulcerative colitis patients and 76% of polyposis patients (P < 0.05). Our data demonstrate that the long-term outcome of ileal pouch-anal anastomosis is more favorable in polyposis patients than in colitis patients. Pouchitis is a major long-term complication occurring exclusively in colitis patients.
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PMID:Postoperative and long-term results of ileal pouch-anal anastomosis for ulcerative colitis and familial polyposis coli. 133 7

To assess prognostic factors in patients who develop colorectal cancer before the age of 40 years, a 30-year experience from 1956 through 1985 was reviewed. There were 50 patients ranging in age from 7 to 39 years. Five cases were associated with either ulcerative colitis (2) or familial polyposis (3). The most common presenting symptoms were abdominal pain (66 percent), hematochezia (60 percent), change in bowel habit (41 percent) and weight loss (30 percent). On pathologic staging (N = 44), only 14 of 44 (31 percent) had a Dukes' stage A or B lesion, 20 (45 percent) had Dukes' stage C, and the remaining 10 (23 percent) had distant metastases at the time of surgery. Five-year survival rate was 28 percent with a disease-free survival rate of 18 percent. Median survival was only 28 months. Negative prognostic factors were Dukes' stage C/D (P less than .001), symptom duration of longer than 3 months (P = .01), noncaucasian ancestry (P = .01), and poorly differentiated histology (P = .06). In contrast to older patients with colorectal cancer, only 1 of 30 (3 percent) patients with stage C D disease was disease-free at 5 years. In view of the poor survival rate associated with both delay in diagnosis and the presence of advanced disease, it was concluded that young patients presenting with the symptoms listed above need early, aggressive evaluation for possible colorectal cancer.
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PMID:Colorectal cancer in patients younger than 40 years of age. 279 69

Colonic lymphoid hyperplasia has been diagnosed in 10 children, aged from 11 months to 12 years, with heterogeneous clinical symptoms such as rectal bleeding, abdominal pain, chronic diarrhea and constipation. The Authors underline the value of endoscopy in the diagnosis of colonic lymphoid hyperplasia which also permitted to exclude other colonic diseases often misdiagnosed by double contrast barium enema (familial polyposis, lymphoid polyps, Crohn's disease, Ulcerative colitis). In This study the Authors discuss the probable etiopathogenetic mechanisms and the prognosis of colonic lymphoid hyperplasia: it should be considered as a benign conditions reflecting a non-specific response to different stimuli.
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PMID:[Endoscopic study in the diagnosis of nodular lymphoid hyperplasia of the colon in childhood]. 383 43

The incidence of periampullary carcinoma is increased in patients with familial polyposis coli or the Gardner syndrome. Patients with familial polyposis coli and ampullary tumors usually present with obstructive jaundice or abdominal pain. We report the case of a 41-year-old woman with the Gardner syndrome in whom relapsing acute pancreatitis was the presenting manifestation of an ampullary neoplasm. A diagnosis of ampullary neoplasm should be considered in any patient with familial polyposis coli or the Gardner syndrome and pancreatitis, even in cases of relapsing acute pancreatitis.
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PMID:Relapsing acute pancreatitis as the presenting manifestation of an ampullary neoplasm in a patient with familial polyposis coli. 402 80

The authors present their experience on a case of Peutz-Jeghers syndrome. Initially described in 1921, the association of intestinal polyposis with pigmentation of the skin and mucous membranes has been called the Peutz-Jeghers syndrome; the pigment, which is melanin, usually involves the lips and mouth and at times the face and extremities. The syndrome appears to be a hereditable disease. Polyps may be present in the stomach, small bowel and colon, but are most frequent in the small bowel, where they produce intussusception or bleeding. Our patient, a 35-year-old man, presented abdominal pain and recurrent intestinal bleeding. Our aim was to evidence radiological signs of this syndrome. the radiographic examination of small bowel, showing multiple polyps and signs of intussusception, definitely confirmed the diagnosis. The Authors finally discuss the possibility of other syndromes associated with gastrointestinal polyposis such as familial polyposis, Cronkhite-Canada syndrome, Gardner syndrome etc.
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PMID:[Radiological aspect of Peutz-Jeghers syndrome: considerations on a case]. 621 Oct 21

Several authors have reported regression of rectal polyps after administration of sulindac in patients with familial adenomatous polyposis (FAP) and subtotal colectomy. However, only a few reports have been published about the effect of sulindac in the intact colon of FAP-patients. 12 patients (FAP n = 10, Lynch-I-syndrome n = 1, juvenile polyposis n = 1/patient with intact colon n = 6, ileorectal anastomosis n = 4, right-sided hemicolectomy n = 2) have been treated with sulindac (3 x 100 mg/d orally) for 4 months. In all patients colonoscopy (if postcolectomy, rectoscopy) with videotape documentation was performed before and after sulindac therapy. Some polyps were excised for histology. In 11/12 patients a regression of the number and size of polyps occurred. In addition, in patients with intact colon no polyps were observed proximal to the sigmoid colon. In one patient sulindac had to be discontinued after 4 weeks' course because of abdominal pain. A control colonoscopy revealed only slight reduction in polyps. In 3/12 patients no polyps remained after sulindac. In a further 3/12 patients with initial tubulous adenomatous polyps, only microadenomas were observed after treatment. We therefore conclude that sulindac is effective in FAP-patients (and very probably in other hereditary polyposis syndromes) with intact colon as well as after (hemi-)colectomy in reducing the number and size of polyps. Long term studies are needed to clarify the optimal dosage, treatment time period, and long term potential for development of carcinoma under sulindac treatment.
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PMID:[Sulindac in familial adenomatous polyposis coli--preliminary findings of a prospective study]. 819 Dec 70

The current treatment of choice for patients requiring colectomy for ulcerative colitis or familial adenomatous polyposis (FAP) is ileoanal anastomosis with pouch creation. Symptomatic inflammation of this pouch, a condition known as pouchitis, will develop in up to 40% of patients who undergo this surgery. Patients will present with crampy abdominal pain, fever, rectal bleeding, and diarrhea, and they may have either acute intermittent attacks or a chronic pouchitis syndrome. Most reported cases of pouchitis have occurred in patients with a previous history of ulcerative colitis, whereas complications develop in only a handful of patients with FAP. The etiology of pouchitis is probably a multifactorial event involving genetic, immune, microbial, and toxic mediators. The initial medical management of pouchitis usually relies on metronidazole; however, other drugs that are useful for ulcerative colitis have been found to be beneficial for pouchitis. Studying the etiology and management of pouchitis may help elucidate the pathogenesis of inflammatory bowel disease.
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PMID:Pouchitis: pathogenesis, diagnosis, and management. 879 43

From 1979 to 1995, 27 patients who had familial adenomatous polyposis (FAP) were treated at the authors' institution. Most patients (n = 23) presented as a result of a previous family history of FAP. Eighteen patients presented with symptomatic colonic disease that included bloody stools (n = 14), diarrhea (n = 10), and abdominal pain (n = 6). Treatment consisted of a total colectomy, rectal mucosectomy, and straight endorectal pull-through (ERPT) in 26 of 27 patients. One patient preferred to undergo an ileoanal J pouch reconstruction. A temporary diverting loop ileostomy was performed in 25 patients and closed at an average of 100 days after the ERPT. Follow-up has been achieved in 100% of the patients and ranges from 6 to 182 months with an average of 48 months. Postoperative complications included partial bowel obstruction (two patients, one requiring enterolysis); and mild pouchitis (one patient). Two of the 27 patients required proctectomy and permanent ileostomy procedures, one for rectal cancer that was present microscopically in the initial rectal specimen from the ERPT and the other because of recurrent anastomotic complications. No patient required revision of the straight pull-through to a pouch or takedown of the pull-through as a result of persistent diarrhea or dissatisfaction. All of the patients are continent, and 80% deny any soiling during bouts of gastroenteritis. The mean number of bowel movements reported was 10 per day at the first postoperative clinic visit with a gradual decreased to six per day after 2 years. Initial use of bulking (62%) and antimotility agents (88%) decreased significantly over the course of follow-up to 29% and 67%, respectively at the most recent follow-up (average, 48 months) of each patient. Pelvic sepsis, which occurs in 8% of most series of patients who have pouches, did not occur in any of our patients. Pouchitis, a common complication with pouches (23%), occurred in only one of the patients and was mild and easily treated medically. This series demonstrates that total colectomy with rectal mucosectomy and straight ERPT eliminates the risk of colorectal cancer and achieves continence with a low complication rate and excellent functional results and patient satisfaction.
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PMID:Efficacy of the straight endorectal pull-through in the management of familial adenomatous polyposis--a 16-year experience. 926 57

Mesenteric fibromatosis is a rare, benign fibrous lesion found in the bowel mesentery or the retroperitoneum. Its biological behavior is intermediate between benign fibrous tissue proliferation and fibrosarcoma. Fibromatosis characteristically is locally invasive and tends to recur but does not metastasize. Most reported cases have been in older individuals, and there is a frequent association with familial polyposis coli, previous trauma, and hormonal imbalance. The authors report a case of mesenteric fibromatosis in a 32-month-old girl with a 1-month history of abdominal pain who was discovered to have an abdominal mass. After appropriate investigations, the mass was excised. The pathology report confirmed the diagnosis of fibromatosis. Mesenteric fibromatosis in children, as in adults, presents a management challenge for the surgeon.
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PMID:Mesenteric fibromatosis: case report and literature review. 1044 7


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