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

Lassa fever is an acute viral illness caused by Lassa virus, which is hosted by rodents in the Mastomys natalensis species complex and rarely imported to countries outside of those areas in Africa where the disease is endemic. Lassa fever is characterized by fever, muscle aches, sore throat, nausea, vomiting, and chest and abdominal pain. Approximately 15%-20% of patients hospitalized for Lassa fever die from the illness; however, approximately 80% of human infections with Lassa virus are mild or asymptomatic, and 1% of infections overall result in death. On August 28, 2004, a man aged 38 years residing in New Jersey died from Lassa fever after returning from travel to West Africa. This report summarizes the clinical and epidemiologic investigations conducted by federal, state, and local public health agencies. The findings illustrate the need for clinicians and public health officials to remain alert to emerging infectious diseases and to institute appropriate measures to promptly identify and limit spread of unusual pathogens.
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PMID:Imported Lassa fever--New Jersey, 2004. 1572 58

While irritable bowel syndrome (IBS) is common in the West, early studies suggest that the prevalence is low in developing countries. However, recent studies point to increasing prevalence in newly developed Asian economies. The presentation appears to differ from the West, with a lack of female predominance, a greater frequency of upper abdominal pain and defecatory symptoms perceived as being less bothersome. This difference, together with the preoccupation with organic disease, could explain why we may be missing IBS in Asia and also why excess surgery has been observed in some Asian countries. While a recent study from China, consistent with western studies, support an important role for infection and inflammation, early studies from India reporting no association between amoebic infection and IBS appear to dispute this observation. To reconcile these seemingly contradictory observations, an hygiene hypothesis model is proposed. Exposure to a variety of microorganisms early in life could result in the colonization of the intestine with microflora that can respond more efficiently to an episode of gastroenteritis. Together with the changes with evolution of Asian economies such as westernization of the diet and increased psychosocial stress, it is proposed that loss of this internal protective effect, could give rise to a more uniform worldwide prevalence of IBS.
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PMID:Irritable bowel syndrome in developing countries--a disorder of civilization or colonization? 1633 5

Autoimmune pancreatitis is a rare but important cause of pancreatitis that is becoming increasingly recognized in the West. Lymphoplasmacytic sclerosing pancreatitis (LPSP) is a benign form of chronic pancreatitis characterized clinically by infrequent attacks of abdominal pain, jaundice, and weight loss, and pathologically by focal or diffuse chronic or lymphoplasmacytic inflammatory infiltrates centered around pancreatic ducts and ductules, accompanied by obliterative phlebitis, acinar atrophy, and interstitial fibrosis. It has been described alone or as a part of the spectrum of autoimmune gallbladder and biliary tract disease, with clinical, radiological, and pathological overlap reported with primary sclerosing cholangitis. It has been described as "primary sclerosing pancreatitis," "sclerosing cholangitis," "non-alcoholic duct destructive chronic pancreatitis," and "autoimmune pancreatitis." We report a case of LPSP that mimicked pancreatic adenocarcinoma and was subsequently treated with a pylorus-preserving Whipple procedure. This may point towards a primary biliary autoimmune process involving the pancreatic duct, causing a benign form of chronic pancreatitis that may be difficult to characterize pre-operatively to avoid surgery. This case typifies the growing awareness of this relatively recently characterized clinical entity, its similar presentation to pancreatic carcinoma, and the importance for LPSP to be included in the differential diagnosis of pancreaticobiliary disease. Finally, we review the literature.
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PMID:Lymphoplasmacytic sclerosing pancreato-cholangitis: a case report and review of the literature. 1598 43

We studied early clinical features of the West Nile virus (WNV) infection. Case patients were Ohio residents who reported to the Ohio Department of Health from August 14 to December 31, 2002, with a positive serum or cerebrospinal fluid for anti-WNV IgM. Of 441 WNV cases, medical records of 224 (85.5%) hospitalized patients were available for review. Most frequent symptoms were fever at a temperature of 38.0 degrees C or higher (n = 155; 69.2%), headache (n = 114; 50.9%), and mental status changes (n = 113; 50.4%). At least one neurological symptom, one gastrointestinal symptom, and one respiratory symptom was present in 186 (83.0%), 119 (53.1%), and 46 (20.5%) patients, respectively. Using multivariate logistic regression and controlling for age, we found that the initial diagnosis of encephalitis (P = .001) or reporting abdominal pain (P < .001) was associated with death. Because initial symptoms of WNV infection are not specific, physicians should maintain a high index of suspicion during the epidemic season, particularly in elderly patients with compatible symptoms.
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PMID:The epidemiology and early clinical features of West Nile virus infection. 1603 27

Thrombotic thrombocytopenic purpura (TTP) is a rare and often fatal disorder characterized by thrombocytopenia, microangiopathic hemolytic anemia, mental status changes, and renal dysfunction. Central diabetes insipidus (CDI) is a rare disease due to anatomic lesions of the hypothalamicpituitary system associated with various underlying diseases, or trauma. We present an unusual case of TTP and CDI in a 47 year-old African American female who was admitted to our hospital with crampy abdominal pain and nausea. The patient had tachycardia, fever and hypotension. The patient subsequently became confused, developed seizures, and her renal function deteriorated. Bone marrow analysis showed adequate megakaryocytes while a peripheral smear revealed severe thrombocytopenia, polychromasia and schistocytes. The diagnosis of thrombotic thrombocytopenic purpura (TTP) was made and plasmapharesis initiated. Over the next few days, the patient developed severe polyuria with a rise in serum sodium. Central diabetes insipidus was diagnosed and DDAVP (desmopressin acetate, 1-deamino-8-D-arginine vasopressin) was given. However, DDAVP was stopped several times due to worsening thrombocytopenia. Renal function worsened and the patient expired. A review of the literature revealed only one case of report of TTP and central diabetes insipidus. Our case was the only one reporting the use of DDAVP in such a setting.
Proc West Pharmacol Soc 2005
PMID:Unique case of thrombotic thrombocytopenic purpura and diabetes insipidus. 1641 83

Whilst only fifteen cases of extrarenal Wilms' tumour (EWT) have been documented in adults, only two previous cases were located in the retroperitoneal space. We report a case of a 21-year-old Saudi female who presented with severe abdominal pain associated with a large solid tumour filling most of the left side of the abdomen and extending across the midline to the right side. Following surgical removal of this retroperitoneal mass, histopathological examination showed the classical features of Wilms' tumour. Both kidneys did not show any primary lesion. The local tumour recurrence responded to Wilms' tumour chemotherapy regimen. The literature on EWT is also reviewed, and the possible mechanism of histogenesis is discussed.
West Afr J Med
PMID:Adult extrarenal Wilms' tumour: A case report and review of literature. 1672 64

Egyptian workers at sewage treatment plants (STPs) work and live in areas, which are highly infested with arthropods. Most of these diseases cause, febrile, influenza like illness, headache, backache, abdominal pain, and fatigue. To determine arboviral etiology in those workers, 264 serum samples were obtained from the workers in four STPs during January and October 1999. Enzyme linked immunosorbent assay (ELISA) was performed for immunoglobulins (IgG and IgM), for the detection of West Nile (WN), Sindbis (SIN), Rift Valley fever (RVF), Sandfly Naples (SFN) and Sandfly Sicilian (SFS) viruses. The results showed that (WN) has the highest prevalence (143/264, 54.14%), followed by (SFN) (58/264, 21.97%) then (RVF) (23/264, 7.95%), while, only one recent infection for each of RVF, SFS and SFN (1/264, 0.38%) and 3 persons for SIN viruses. Out of the four STPs Helwan workers' exhibited the highest infection rate for most of the studied arboviruses WN, SFN, SIN and SFS.
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PMID:Infection by certain arboviruses among workers potentially at risk of infection. 1721 41

Lassa fever is an acute viral zoonotic illness caused by Lassa virus, an arenavirus known to be responsible for a severe haemorrhagic fever characterised by fever, muscle aches, sore throat, nausea, vomiting and, chest and abdominal pain. The virus exhibits persistent, asymptomatic infection with profuse urinary virus excretion in the ubiquitous rodent vector, Mastomys natalensis. Lassa fever is endemic in West Africa and has been reported from Sierra Leone, Guinea, Liberia, and Nigeria. Some studies indicate that 300,000 to 500,000 cases of Lassa fever and 5000 deaths occur yearly across West Africa. Studies reported in English, that investigated Lassa fever with reference to West Africa were identified using the Medline Entrez-PubMed search and were used for this review. The scarcity of resources available for health care delivery system and the political instability that characterise the West African countries would continue to impede efforts for the control of Lassa fever in the sub-region. There is need for adequate training of health care workers regarding diagnostics, intensive care of patients under isolation, contact tracing, adequate precautionary measures in handling infectious laboratory specimens, control of the vector as well as care and disposal of infectious waste.
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PMID:Lassa fever in West African sub-region: an overview. 1737 12

Although Crohn's disease is thought to be rare and intestinal tuberculosis common in India, Crohn's disease is being reported more often. However, there is a lack of systematic study on Crohn's disease from India. In this analysis of data from three inflammatory bowel disease clinics (two in northern India and one in eastern India), criteria for Crohn's disease were applied retrospectively: (1) World Health Organization (WHO) criteria; or (2) compatible histology (European Crohn's and Colitis Organization) or failure of response to 4-8 weeks of anti-tuberculosis therapy (Asia-Pacific guidelines); or (3) compatible macroscopic, radiologic, colonoscopic features (European Crohn's and Colitis Organization). Others were classified as probable Crohn's disease. The Montreal classification was used for disease phenotype. Age at onset and duration of symptoms (182 patients, 117 male) were 34.5 (+/-13.6; 7-73) years and 3.0 (+/-5.8; 0.1-36) years, respectively. Diarrhea (68%), abdominal pain (62%), and weight loss (57%) were common. The common intestinal complications were occult (27%) and overt (40%) gastrointestinal bleeding and obstruction (28%). There were 141 (78%) and 41 (22%) with definite and probable Crohn's disease respectively. Of 147 (81%) available histopathology specimens (endoscopic biopsy in 110; 75%), 31 (21%) had granuloma. Seventy-one out of 166 (43%) had received anti-tuberculosis therapy in the past. Results from the Montreal classification were as follows: age at onset, A1:A2:A3 6%:64%:30%; location of disease, L1:L2:L3:L4 32%:41%:23%:4%, and disease behavior, B1:B2:B3 51%:24%:25%. Twenty-six (15%) and 31 (17%) patients had upper gastrointestinal and perianal modifiers. The drugs used were: aminosalicylates (128, 70%), steroids (76, 42%), azathioprine (53, 29%), methotrexate (4, 2%), and salazopyrine (14, 8%). Sixty-six (36%) patients underwent surgical treatment. We concluded that the phenotype of Crohn's disease in India is very similar to that described in other regions of Asia and the West, except for a delay in diagnosis and a more complicated disease at diagnosis.
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PMID:Crohn's disease in India: a multicenter study from a country where tuberculosis is endemic. 1877 37

THIS CASE REPORT DESCRIBES AN ATYPICAL PRESENTATION OF AN ATYPICAL DISEASE ENTITY: Emphysematous Cystitis, a rapidly progressive, ascending urinary tract infection, in an emergency department (ED) patient whose chief complaint was abdominal pain and who had a urinalysis not consistent with the diagnosis of cystitis.
West J Emerg Med 2008 Aug
PMID:A Case of Complicated Urinary Tract Infection: Klebsiella pneumoniae Emphysematous Cystitis Presenting as Abdominal Pain in the Emergency Department. 1956 37


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