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

The torsion of spleen on its vascular shank represents an uncommon problem, responsible of acute and chronic pain. The mobile spleen is fixed only through hilus vessels the gastrosplenic ligament. The incidence is unknow, greater in the male with an M:F ratio 6.1 in the first ten years of life, even if an episode of intrauterine torsion has been reported. The diagnosis can be performed with ultrasonography, angiography, scintigraphy and CT scan. There are reported two cases: male of 2.5 years female of 14 years who presented with recurrent pain to the left side, vomit diarrhoea and fever. Objectively a palpable mass was present. Ultrasonography and angio-CT scan of abdomen revealed splenomegaly, ptosis of the spleen and malrotation with signs of obstruction of the vessels. The treatment in both cases was splenectomy. The spleen appeared rotated on its shank and increased of volume, deprived of anatomical structures of fixation. The histological report confirmed the haemorrhagic infarction. The excessive mobility of the spleen, from insufficiency or absence of the ligamentous attachments is case of abdominal pain or acute abdomen, that can complicate with the infarction of the spleen. Angio-CT scan, in the cases here reported, has shown to greater sensibility in comparison to the ultrasonography. The Authors believe that the video-laparoscopic splenopexy, when the diagnosis is made of "wandering spleen" with painful repeated episodes, can be finalized, to the preservation of organ.
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PMID:[Uncommon etiology of acute abdomen in pediatric age: the torsion of spleen]. 1584 92

Emergency consultations happen frequently in gynaecology and may be due to abdominal pain, itching, utero-vaginal bleeding, rape, emergency contraception, insertion of foreign bodies, prolapse and urinary tract infection. Considering pregnancy in patients with child bearing potential is essential. Vaginal bleeding may be due to atrophy, infection, carcinoma or pregnancy. In the latter it is crucial to differentiate between ectopic, pathologic or physiologic pregnancy. In postmenopausal women further investigations by the gynaecologist are mandatory to exclude malignancy. Patients who have been raped need psychological, forensic and gynaecological support. Sexually transmitted disease including HIV must be considered and prophylactic drugs should be administered. If unprotected intercourse has occurred the "morning after pill" can be considered within 72 hours after intercourse or an IUD up to five days. Prolapse occurs rarely as an acute problem but may induce urinary retention. Urinary tract infection is a common complaint and should be treated with antibiotics.
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PMID:[Emergencies in gynecology--what must I not forget?]. 1599 32

A 22-year-old, primigravida +/- 20 weeks of gestation presented with abdominal pain. She was diagnosed as a case of advanced cervical incompetence. We carried out an emergency cerclage after 24 hours from her admission, while the cervix was fully dilated with bulging of the membranes and prolapse of both lower limbs in the middle of the vagina. She delivered normally at 38 weeks of gestation with favorable outcomes. We believe that even if miscarriage is inevitable, the so called emergency cerclage might be considered.
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PMID:Emergency cerclage. A successful challenge despite advanced second trimester cervical dilatation. 1659 37

Surgical correction of pelvic organ prolapse is increasingly common. The vaginal approach is often favored secondary to its limited peritoneal cavity access and low complication rates. A thorough review of the literature revealed no previous reports of primary vaginal reconstructive surgery leading to small bowel obstruction (SBO). Three patients who underwent transvaginal hysterectomy, uterosacral ligament vaginal vault suspension, and other reconstructive procedures subsequently suffered from SBO. All patients failed conservative management and required surgery. All were treated with laparoscopy initially, but two patients required laparotomy to correct iatrogenic enterotomies. The complication of SBO should be considered in the post vaginal surgery patient with abdominal pain. Though laparoscopic surgery can be considered, our experience has been discouraging. Candidate selection is critical and care should be taken to avoid enterotomy.
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PMID:Small bowel obstruction after vaginal vault suspension: a series of three cases. 1738 18

Submucosal lipomas are usually harmless neoplasms arising from submucosal adipocytes. They are found most commonly in the colon, but may develop in any part of the gastrointestinal tract. Most colonic lipomas are asymptomatic and need no treatment, whereas larger ones (>2 cm) may present with abdominal pain, changes in bowel habits, rectal bleeding, and intussusception or prolapse. The literature on the endoscopic resection of colonic lipomas is limited owing to the increased risk of colonic perforation. In this paper, we describe a novel technique for the treatment of colonic obstruction resulting from a giant lipoma by placing two large clips at the narrow base of the lipoma and performing multiple cuttings on the mucosa covering the fatty tissue by using a needle-knife to facilitate the fat's discharge into the colon's lumen. Our case showed that the endoclipping of semi- or pedunculated large colonic lipomas not amenable for endoloop ligation and associated with cuttings of the mucosa covering the fat is a promising new technique, which avoids the risk of perforation or bleeding of the snare cautery, especially in high-risk patients.
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PMID:A novel technique for the treatment of a symptomatic giant colonic lipoma. 1770 28

Vascular abnormalities of the intestines are unusual. We present a florid benign vascular proliferation of the jejunum in one adult patient, presented with intussusception. In this cases, the proliferation was sufficiently exuberant to raise the possibility of angiosarcoma as a diagnostic consideration. The patient was 81-years old female. The main clinical symptoms at presentation included abdominal pain and bowel obstruction. On exlorative laparotomy two jejunal masses were found. Histologically in these lesions a florid lobular proliferation of small vascular channels lined by plump endothelial cells extended from the submucosa through the entire thickness of the bowel wall. The endothelial cells showed minimal nuclear atypia, and mitotic figures were infrequent. The overlying mucosa showed ulceration with ischemic-type changes, and had features of mucosal prolapse. The presence of intussusception or mucosal prolapse in the case suggests repeated mechanical forces applied to the bowel wall as a possible etiologic factor.
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PMID:[Rare case of florid vascular proliferation of small intestine complicated with intussusception and bowel obstruction]. 1868 Nov 50

Colon polyps are a common finding in pediatrics and can present with rectal bleeding, abdominal pain, or polyp prolapse from the rectum. Histologically classified as hamartomas, these isolated pediatric polyps lack epithelial dysplasia and have no cancer risk. However, when polyps are present in greater numbers, or are associated with a family history of polyps or colon or other cancers, a polyposis or hereditary colorectal cancer syndrome should be considered. Using a case-based format, this article reviews the clinical features and provides updates on the three most common hamartomatous polyp syndromes of childhood: juvenile polyposis syndrome, Peutz-Jeghers syndrome, and the PTEN hamartoma tumor syndrome. Each syndrome has distinctive intestinal and extra-intestinal findings that, when present, can guide genetic counseling and testing. Lifelong cancer surveillance is crucial to disease prevention and the long-term health of these patients and their families.
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PMID:Pediatric juvenile polyposis syndromes: an update. 1946 21

Snakebite is an environmental hazard associated with significant morbidity and mortality. We report a case series of venomous snakebites in a military operational area of north India. Of 33 cases of snake bites presenting to the military hospital, 21 patients were envenomated. The median age of patients was 24 years; all were men. All of the envenomations were neurotoxic in nature. Abdominal pain (91%), headache (86%), dysphagia (86%), ptosis (77%), diplopia (72%), blurred vision (72%), dyspnea (67%), and vomiting (62%) were the predominant clinical presentation. Polyvalent AntiSnakeVenom (ASV) [mean 180 ml; range 90-320 ml] was given to all patients with systemic manifestations, and repeated as needed. Eleven (52%) patients received neostigmine with glycopyrrolate to counter cholinergic effects. Two patients were given ventilatory support. The average time of recovery from envenomation was 16 hours after administration of ASV. All patients recovered without sequelae. Soldiers during military exercise are vulnerable to snakebites. Neurotoxic snakebites predominate in our study and usually present with autonomic features along with headache, abdominal pain, ptosis, diplopia and dysphasia. Preventive measures to minimize snake bites and planned treatment regimens should be emphasized among medical and military personnel deployed in the field operations.
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PMID:Clinical profile of venomous snake bites in north Indian Military Hospital. 1956 85

Infection of the central nervous system with Nocardia sp. usually manifests as supratentorial abscesses. Supratentorial and cerebellar abscesses from infection with Nocardia sp. following immunosuppression with long-term corticosteroids for idiopathic thrombocytopenia (ITP) have not been reported. An 83 years-old, human immunodeficiency virus (HIV)-negative, polymorbid male with ITP for which he required corticosteroids since age 53 years developed tiredness, dyspnoea, hemoptysis, abdominal pain, and progressive gait disturbance. Imaging studies of the lung revealed an enhancing tumour in the right upper lobe with central and peripheral necrosis, multiple irregularly contoured hyperdensities over both lungs, and right-sided pleural effusions. Sputum culture grew Nocardia sp. Neurological diagnostic work-up revealed dysarthria, dysphagia, ptosis, hypoacusis, tremor, dysdiadochokinesia, proximal weakness of the lower limbs, diffuse wasting, and stocking-type sensory disturbances. The neurological deficits were attributed to an abscess in the upper cerebellar vermis, myopathy from corticosteroids, and polyneuropathy. Meropenem for 37 days and trimethoprime-sulfamethoxazole for 3 months resulted in a reduction of the pulmonary, but not the cerebral lesions. Therefore, sultamicillin was begun, but without success. Long-term therapy with corticosteroids for ITP may induce not only steroid myopathy but also immune-incompetence with the development of pulmonary and cerebral nocardiosis. Cerebral nocardiosis may not sufficiently respond to long-term antibiotic therapy why switching to alternative antibiotics or surgery may be necessary.
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PMID:Cerebellar nocardiosis and myopathy from long-term corticosteroids for idiopathic thrombocytopenia. 2004 27

This light microscopic retrospective study of 798 cervical smear were done to see the pattern of cervical lesions and main presenting complaints of the women who attended the Gynae & Obstetrics department of BIRDEM hospital for medical and surgical advice. Out of these 798 smears examined light microscopically 274(34.34%) was normal, 453(54.26%) were inflammatory smear, 49(6.14%) showed Gardrenella, 9(1.13%) revealed the presence of Candida, 3(0.38%) showed Trichomonial infection, 6(0.76%) showed the presence of atypical cells (5ASCUS, 1 CIN) and 2(0.26%) were positive for malignancy, (1 adenocarcinoma, 1 squamous cell carcinoma). The mean age+/-SE of the women were 43.12+/-9.18 years, mean+/-SE age of the last child was 14.19+/-7.99 years; mean+/-SE of para was 3.5+/-7.34 pregnancies. The common presenting complains of these women Menorrhagia (17.92%), Menopausal Symptoms (17.42%), Lower Abdominal pain (15.78%), White PV discharge (15.78%), Dysmenorrhoea (7.52%), Pruritus/Itching vulva (7.14%), Prolapse (4.39%), Fibroid (2.01%), Infertility (1.13%), Post coital bleeding (0.75%) respectively. Pap's smear is reconfirmed as an established major screening tool for diagnosis of different cervical lesions.
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PMID:Light microscopic study of cervical smear in a tertiary hospital at Dhaka. 2039 13


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