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

Twenty five cases of Burkitt's lymphoma in Thai children were diagnosed at the Department of Pediatrics, Siriraj Hospital during the period of 13 years (January 1969 to April 1982). Males were more affected than females with the ratio of 1.7:1. The age ranged from 2 to 11 years with the median age of 4-5 years. The most common clinical manifestations were abdominal mass associated with nausea vomiting, abdominal pain, anorexia, weight loss and generalized lymphadenopathy which occurred in 50-60% of cases. Additional symptoms and signs included anemia, hepatosplenomegaly, edema and pleural effusion. Jaw tumor was found in only 37.5% of the patients. Definite diagnosis depended on the characteristic starry sky appearance of the lymph node biopsy or section of abdominal mass. In advance cases, the tumor cells could be discovered in bone marrow aspiration, ascitic fluid pleural fluid and cerebrospinal fluid. The typical blast cells were detected in the peripheral blood in 4 cases. Antibody to Epstein-Barr virus could be detected in almost all cases with high titers in some cases. Most patients responded very well to local irradiation and chemotherapy with prednisolone plus cyclophosphamide and vincristine or methotrexate. However, relapse occurred rapidly and 80% of the patients died within 3 months after diagnosis with the median survival of only 1 month. Five cases expired early before any specific treatment. The main causes of death were disease, sepsis, excessive bleeding and hyperkalemia.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Burkitt's lymphoma in Thai children: an analysis of 25 cases. 631 66

This paper reviews a series of gastric perforations resulting from blunt abdominal trauma. Over an 8-year period from January 1, 1974 to December 31, 1982, a total of 1412 patients were treated for significant intra-abdominal injuries. All injuries resulted from blunt abdominal trauma. Patients were transported by helicopter to our statewide trauma center. Fourteen patients sustained 47 perforating injuries to the gastrointestinal tract; six patients (0.4%) had gastric perforations and averaged 1.3 associated intraabdominal injuries. The gastric injuries included three greater curve lacerations: one anterior wall tear, 10 cm long, extended through the esophagogastric junction, and two lacerations involved the anterior wall of the distal antrum. Five of the six patients (83.3%) complained of severe abdominal pain on admission and had bloody returns from subsequent peritoneal lavages. The sixth patient had two negative lavages 7 hours apart but underwent laparotomy for persistent symptoms. Five patients had upright chest roentgenograms, and one patient demonstrated free subdiaphragmatic air. Patients with severe abdominal pain following blunt abdominal trauma require early celiotomy. Classic diagnostic findings, e.g., free intraperitoneal air, shock, and positive paracentesis, may be absent. The gastric injuries were repaired with a two-layer technique. Two patients (33%) developed intra-abdominal sepsis and required surgical drainage. One patient required pyloroplasty and vagotomy for stress-induced gastric bleeding. All six patients survived. The high mortality of gastric perforation can be mitigated by early diagnosis and surgical intervention.
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PMID:Gastric rupture from blunt trauma. A plea for minimal diagnostics and early surgery. 633 79

We describe the case of a 58-year-old man who presented to the hospital with central abdominal pain, nausea, fever, chills, and dyspnea. While in the hospital, jaundice appeared and the liver function tests revealed features of both cholestasis and hepatocellular injury. He developed gram-negative septicemia and died on the sixth hospital day. Autopsy disclosed a perforated terminal ileal diverticulum and a contiguous mesenteric abscess. There was also severe phlebitis of mesenteric venous radicles which extended superiorly to the intrahepatic portal venules and veins. The portal veins were surrounded by multiple hepatic abscesses that varied in size from microscopic to 2.5 cm. This appears to be the first report in the world literature of suppurative pylephlebitis and hepatic abscesses resulting from a perforated ileal diverticulum. The subject of small bowel non-Meckelian diverticulosis is reviewed because of the rarity of this condition and the diagnostic challenges it poses.
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PMID:Perforated diverticulum of the terminal ileum. A previously unreported cause of suppurative pylephlebitis and multiple hepatic abscesses. 642 54

A patient with a Billroth II resection and Crohn's disease subsequently developed obstructive jaundice and biliary sepsis. Three hepatic duct stones were demonstrated by ERC. After overcoming the obstruction by means of temporary retrograde internal drainage, perfusion of glyceryl-1-monooctanoate-carnosine and bile-acid-EDTA solution (2) was combined with sucralfate instillation into the blind loop via a duodenal tube. During successful treatment of the cholangiolithiasis, no deterioration of Crohn's disease was seen. Secondary effects such as abdominal pain or diarrhoea, were treated symptomatically.
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PMID:Dissolution of biliary duct stones without papillotomy in a patient with Billroth II resection and Crohn's disease. 642 68

Postoperative outcome was compared for 235 patients who were sterilized by unipolar tubal electrocoagulation and for 269 patients who were sterilized by the application of Hulka Clemens spring-loaded tubal clips. Clip application patients had fewer complications but experienced more postoperative discomfort than electrocautry patients. All the sterilizations were performed by the same physician at the Aberdeen Royal Infirmary from 1976-1978. All the patients received general anesthesia, administered by the same anesthetist. Operating time for the tubal electrocautery technique was 7.5 minutes and 5.5 minutes for the tubal clip procedure. 14 of the electrocautery patients and 6 of the clip application patients experienced complications. For the electrocautery patients 1) 11 experienced tubal bleeding and laporotomy to stop bleeding was required for 2 of the patients; 2) 1 patient received bowel damage; and 3) 2 patients had uterine perforations. For the 6 tubal clip patients 1) 2 had uterine perforation; 2) 1 had pelvic sepsis; and 3) in 3 of the patients clips were lost and not retrieved. Only 1 pregnancy was reported, and in that patient adhesions had obstructed the tube during the operation. Immediately following surgery the majority of the patients experienced mild abdominal pain. 9.4% of the clip patients and 1.3% of the electrocautery patients experienced severe pain. 48.5% of the electrocautery patients and 36.0% of the clip patients experienced shoulder pain. Laparoscopic clip sterilization was recommended as a safer technique than electrocoagulation.
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PMID:Outpatient laparoscopic sterilisation: Comparison between electrocautery and clip application. 644 41

Fifty patients undergoing splenectomy for complications of hematologic malignancy were reviewed to define indications and results. Primary diseases included lymphoma (n = 14), chronic lymphatic leukemia (n = 13), hairy-cell leukemia (n = 12), myeloid metaplasia (n = 6), and other similar disorders (n = 5). Indications for splenectomy in these patients included cytopenia (n = 37), diagnostic laparotomy (n = 8), "small stomach" syndrome (n = 3), and abdominal pain (n = 2). Splenectomy was performed by the midline approach in 32 patients. In 40 patients, the splenic artery was ligated prior to mobilization of the spleen. The spleens averaged 1650 g; in eight patients accessory spleens were removed. Additional surgical procedures included liver biopsy (n = 30), lymph node biopsy (n = 15), and cholecystectomy (n = 3). Intraoperative blood loss averaged 750 ml. In 14 patients, drainage of the left subphrenic space was used. Splenectomy was effective in 36 of 50 patients. In seven patients, splenectomy was ineffective in correction of cytopenia. Seven mortalities were from bleeding (n = 2), pulmonary embolus (n = 2), postoperative sepsis (n = 2), and progression of primary disease (n = 1). Additional complications included reoperation for bleeding (n = 3), septic complications including pneumonia (n = 14), wound infection (n = 4), and intra-abdominal abscess (n = 2). Splenectomy for the patients with hematologic malignancy is generally effective. Meticulous hemostasis, timely administration of intraoperative platelets, surgical asepsis, and aggressive pulmonary care are essential to reduce morbidity and mortality.
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PMID:Splenectomy in hematologic malignancy. 646 89

Over the past 9 years, ten patients have presented to the Thoracic Unit, Glasgow Royal Infirmary, with 12 empyemas secondary to intra-abdominal sepsis. In eight patients, the presenting signs and symptoms were wrongly attributed to primary intra-thoracic pathology. All were subsequently found to have intra-abdominal sepsis. The presence of empyema after recent abdominal surgery or abdominal pain strongly suggests a diagnosis of ipsilateral subphrenic abscess. Adequate surgical drainage is essential. In our experience, limited thoracotomy with subdiaphragmatic extension offers the best access to both pleural and subphrenic spaces and provides the greatest chance of eradicating infection on both sides of the diaphragm.
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PMID:Empyema following intra-abdominal sepsis. 647 70

Caroli's disease is a congenital disease of cystic or saccular dilatation of the intrahepatic bile ducts. There are two disease entities: a simple type and a periportal fibrosis type. Frequent complications with the simple type are recurrent cholangitis, liver abscess, intraductal lithiasis, abdominal pain, and fever that often lead to fatal sepsis. Development of portal hypertension and esophageal varices is usually a final feature of the periportal fibrosis type. Malignancies are also possible complications with Caroli's disease. During the recent 13 years, the author had experiences with eight patients with Caroli's disease of the simple type; six of these eight underwent hepatic resection: right lobectomy in two, left lobectomy in three, and left lateral segmentectomy in one. Other two patients died of sepsis and cholangiocellular carcinoma, respectively. All six patients with hepatic resections were relieved from the disabling symptoms after surgery and have had no recurrent hepatobiliary problems for 3 months to 13 years. Hepatic resection may be indicated for more patients than previously assumed in the treatment of Caroli's disease of the simple type.
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PMID:Successful treatment of Caroli's disease by hepatic resection. Report of six patients. 650 1

Information from 2 recent books on the most common abortion techniques is presented. Menstrual aspiration can be performed up to 14 days after a missed period. A flexible plastic cannula 4-5 mm in diameter is passed through the cervix to the uterus, and the contents are evacuated using a syringe. Little dilatation is required and the procedure is done under local anesthesia. Aspiration through the 12th week is usually done under general anesthesia using a cannula and mechanical aspiration. A curette is used to assure that the abortion is complete. Local anesthesia is used in some places. From 12-16 weeks a combination of scraping and aspiration is used with general anesthesia and sometimes forceps. The uterine cervix requires greater dilatation. After 16 weeks the amniotic fluid is removed and a solution of salt and water is injected into the woman under local anesthesia. Contractions begin about 24 hours later. Labor may also be induced by oxytocin or prostaglandins which result in 8-15 hours of labor. This method of abortion probably causes the greatest amount of anxiety in the patient. Uterine scraping is described in the 2nd book as a procedure in which the cervix is progressively dilated with metal instruments of different sizes until it is sufficiently dilated to permit passage of the curette. Laminaria tents were previously placed in the cervix 24 hours prior to the abortion to achieve slow and progressive dilatation. General anesthesia is required because cervical dilatation is painful. In uterine aspiration the contents of the uterus are removed using tubes called Karmen cannulas. It is sometimes possible to avoid cervical dilatation by using thin cannulas, in which case general anesthesia may be avoided. After the aspiration the uterus may be scraped to assure the complete removal of the uterine contents. Prostaglandins may be used to initiate uterine contractions leading to expulsion of the uterine contents during the 2nd trimester of pregnancy. The procedure may cause significant side effects. Other procedures consist of injecting various substances into the uterine cavity during the 2nd trimester of pregnancy. Hysterotomy involves surgical opening of the abdomen and is analogous to cesarean section. Possible complications of an induced abortion include uterine perforation, bleeding, infection, and in extreme cases maternal death through sepsis. Medical attention should be sought in cases of hemorrhage, abdominal pain, fever, or general malaise after an induced abortion.
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PMID:[Literary but technical abortion]. 655 11

Campylobacter jejuni was isolated from 135 infants and children seen at the Oklahoma Children's Memorial Hospital over a 3-year period. The comparative frequency of isolation of C. jejuni, Salmonella, and Shigella were 1.5 percent, 2.2 percent, and 3.1 percent, respectively. Campylobacter enteritis was most prevalent during the warm months from May to October, peaking in July. Seventy percent of the afflicted children were 2 years old or younger; only 13 percent were older than 5 years. There were the usual clinical presentations (acute onset of diarrhea, fever, abdominal pain, and bloody stools) of Campylobacter enteritis, but other, less common, patterns also were seen. These included chronic diarrhea without significant systemic manifestations; asymptomatic bloody stools, particularly in neonates; and fever and abdominal pain without diarrhea. Severe complications included hemolytic-uremic syndrome, sepsis associated with septic arthritis and osteomyelitis, and failure to thrive.
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PMID:Campylobacter enteritis. A 3-year experience. 660 93


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