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

One hundred adolescent clinic patients who complained of chest or upper abdominal pain were evaluated. Seventy-nine were found to have only tender costal cartilages. Costochondritis pain originates in the anterior chest wall and may radiate into the chest, back, or abdomen. It is reproducible by palpating the affected costal cartilage. Costochondritis was more often unilateral than bilateral (P = 0.001), and in unilaterally affected patients (P less than 0.005), is involved the left side more than the right. The left fourth sternocostal cartilage was involved most frequently. A simple program of mild analgesics and reassurances was sufficient treatment in all cases. These findings suggest that chest pain and upper abdominal pain in adolescents rarely arise from serious problems. Adolescents are normally hypersensitive about physical symptoms, but they can be effectively reassured and an expensive diagnostic and treatment program can be avoided.
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PMID:Costochondritis in adolescents. 733 21

Slipping rib syndrome is an unusual cause of lower chest and upper abdominal pain in children not mentioned in major pediatric surgical texts. The syndrome occurs when the medial fibrous attachments of the eighth, ninth, or tenth ribs are inadequate or ruptured, allowing their cartilage tip to slip superiorly and impinge on the intervening intercostal nerve. This may cause a variety of somatic and visceral complaints. Although the diagnosis may be made based on history and physical examination, lack of recognition of this disorder frequently leads to extensive diagnostic evaluations before definitive therapy. The authors report on four children who have this disorder.
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PMID:Slipping rib syndrome in childhood. 924 38

Slipping rib syndrome is a poorly recognised cause of chest and abdominal pain. It occurs principally in the middle-aged but may occur at any age. It is equally common in men and women and is frequently confused with other serious causes of chest and abdominal pain. Patients are often subjected to extensive and sometimes invasive needless investigation for unexplained symptoms. Greater awareness of this syndrome among clinicians could sale both patient and doctor time and unnecessary concern. Two case reports are presented.
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PMID:Slipping rib syndrome: an overlooked cause of chest and abdominal pain. 928 71

We report a case of thoracic wall myositis ossificans (MO) located anterior to the ninth rib, causing right lower thoracic-upper abdominal pain. The diagnosis was based on the findings of ultrasonography (US) and computed tomography (CT). Numerous disorders can be included in the differential diagnosis of right lower thoracic-upper abdominal pain, so we must first establish if the pain is somatic or visceral in origin. Somatic pain in this region can be caused by traumatic muscle pain, overuse myalgia, costochondritis, or thoracic wall malignancies. Although rare, MO should also be considered in the differential diagnosis of pain and thoracic wall masses in this region. As the calcifications may not be seen on a plain chest X-ray in the early course of this condition, superficial tissue US or CT should be performed to establish the diagnosis.
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PMID:Myositis ossificans in the right inferior thoracic wall as an unusual cause of lower thoracic-upper abdominal pain: report of a case. 1882 Aug 77

Sphincter of Oddi dysfunction (SOD) is a poorly-understood disorder, typically presenting as postcholecystectomy, "biliary-type," right-sided abdominal and/or chest wall pain. Most patients referred to specialist clinics for work-up of presumed SOD do not, in fact, have anything wrong with their bile ducts or biliary sphincter mechanisms. A careful history and focused physical examination will often identify the true source of the pain syndrome, ranging from chest wall costochondritis and nerve injury at surgical trochar sites, to gastroparesis and visceral hypersensitivity ("irritable bowel"). The Rome III classification of functional gallbladder and biliary disorders defines SOD as episodic (not daily) pain lasting more than 30 min, which is disruptive of normal activities and not associated with bowel upset. It is not relieved by gastric acid suppression or antispasmodics. Other causes of abdominal pain must be excluded. Standard work-up includes endoscopic retrograde cholangiopancreatography (ERCP) with biliary manometry, which risks post-ERCP pancreatitis, especially in young women with normal bile ducts and liver serology. Noninvasive tests for SOD, such as timed ("gated") cholecystokinin (CCK)-stimulated hepatobiliary iminodiacetic acid (HIDA) scans and secretin-stimulated magnetic resonance cholangiopancreatography, are imperfect and still evolving. Although many doubt the very existence of SOD, a multidisciplinary approach to the management of pre- and postcholecystectomy abdominal pain syndromes is long overdue.
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PMID:Sphincter of Oddi dysfunction. 2042 85

Slipping rib syndrome (SRS) is an unusual cause of recurrent chest or abdominal pain in children. The diagnosis is elusive, including gastroenterological, cardiac, respiratory, infectious and chest or abdominal muscular pathologies. Two paediatric patients were diagnosed with SRS, both of them were female teenagers with a similar clinical pattern: crippling unilateral chest pain without a traumatic event. On physical examination, all patients had reproducible pain with the "hooking maneuver". Surgical excision of the costal cartilages was done, preserving the perichondrium. No complications were reported. In both cases we achieve an excellent outcome after one and four years of follow-up, resolving the symptoms completely. The surgical excision of the costal cartilages seems to be an aggressive option but with an excellent outcome. A minimum invasive approach could be a better option in the future.
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PMID:[Slipping rib syndrome. An aggressive but effective treatment]. 2648 43

A 42-year-old woman presented to our hospital with weeks of worsening pain around her lower ribs. Preceding this, she was managed in primary care with anti-inflammatory drugs and physiotherapy for presumed costochondritis. Assessment in accident and emergency suggested a tender right upper quadrant with fever and neutrophilia. A surgical review of the patient was requested to assess for cholecystitis or delayed pancreatitis. On direct questioning, the patient's back pain was the predominating symptom with no neurological deficit. To assess for delayed pancreatitis, CT imaging was obtained, demonstrating unremarkable intra-abdominal organs. There was also the incidental finding of thickened prevertebral soft tissues anterior to T9 and T10 vertebrae, with vertebral endplate irregularity locally. Subsequent MRI demonstrated typical appearances of infective spondylodiscitis at this level. The patient made a good recovery with intravenous antimicrobials. This case highlights how vertebrodiscitis can present insidiously and unexpectedly, manifesting as abdominal pain.
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PMID:Thoracic spondylodiscitis presenting as abdominal pain. 2681 91

Slipping rib syndrome (SRS) is an under-diagnosed cause of intermittent, yet often debilitating lower rib and abdominal pain. SRS is caused by a hypermobility of the anterior false ribs that allows the 8th-10th ribs to slip or click as the cartilaginous rib tip abuts or slips under the rib above. Pain occurs from impingement of the intercostal nerve passing along the undersurface of the adjacent rib. Studies consistently find patients reporting months to years of typical pain symptoms, unnecessary tests and procedures prior to diagnosis. SRS is a clinical diagnosis, but dynamic ultrasound can be helpful for confirmation or diagnosis in difficult cases. Resection of the slipping rib cartilages is the mainstay of treatment, with good results for pain relief. Rib stabilization is an emerging option for recurrent symptoms.
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PMID:Slipping Rib Syndrome: A review of evaluation, diagnosis and treatment. 3007 90

Slipping rib syndrome is an often unrecognized and underdiagnosed condition caused by the increased mobility of the anterior ends of the costal cartilages of the false ribs. Patients usually present with severe intermittent abdominal pain that is exacerbated by various physical movements. Diagnosis of slipping rib syndrome is mainly clinical and can be confirmed by a physical examination technique termed the "Hooking Maneuver." Treatment includes conservative therapy, intercostal nerve block and surgical operation. Hence, the management and care plan of each patient must be individualized as per the presenting symptoms and medical history. Early recognition and prompt intervention necessitate that physicians be more aware of the symptomatology and prognosis of this condition. This study presents a rare case of a patient with slipping rib syndrome and offers medical insight to the clinical diagnosis and therapeutic modalities of this condition, in light of the current existing literature.
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PMID:Slipping Rib Syndrome: Solving the Mystery of the Shooting Pain. 3050 26

Background: Slipping rib syndrome (SRS) is an often underdiagnosed cause of lower chest wall and abdominal pain. The diagnosis of SRS is established by physical examination with or without dynamic ultrasound. The pain can be debilitating and surgical excision of the nonattached, subluxing cartilages is curative for most patients, but frustratingly, up to a quarter of patients have transient or limited relief and require reoperation. Some of these patients were found to have subluxation of the remaining bony ribs, suggesting that excision of rib cartilage alone may not be curative in a subset of patients. Materials and Methods: A retrospective review was performed of 3 patients with recurrent slipping rib pain and hypermobile bony ribs on reoperation. In an effort to stabilize the hypermobile ribs, vertical bioabsorbable plating across their ribs was performed. The plates secure the ribs apart from each other, preventing the movement of ribs against each other and therefore the pain. Results: All patients tolerated the procedure well. Mean length of stay was 2.6 days. Mean follow-up is 7 months and all report significant improvement in pain. Conclusions: Rib plating allows stabilization of hypermobile ribs, while preserving the patient's anatomical rib cage, and is a safe treatment for recurrent pain after the initial procedure. This is a novel approach in patients with recurrent slipping rib symptoms.
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PMID:Recurrent Slipping Rib Syndrome: Initial Experience with Vertical Rib Stabilization Using Bioabsorbable Plating. 3189 29


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