Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Twenty-six cases of miliary tuberculosis were studied in retrospect. The mean age of the patients was 62 years. Eighteen patients suffered from another underlying chronic disease. Nine had been treated with corticosteroids or cytotoxic agents. A limited manifestation of tuberculosis had been previously verified or suspected in ten cases. Fever was present in 85% of the patients, frequently combined with fatigue or abdominal pain. Serum alkaline phosphatase was elevated in 81% of the cases. Minor haematological abnormalities (anaemia, etc.) were found in 16 cases and pancytopenia, stimulated lymphocytes or chronic myeloid leucaemia in six. Miliary mottling was found in the chest radiographs of 13 patients. Other findings were pleural effusion, mediastinal node enlargement, opacities suggesting pneumonia or old, possibly tuberculous lesions. Antituberculosis therapy was initiated in 12 patients, two of whom died within a few days. There was a high frequency of liver or system involvements. It is concluded that laparoscopy or liver needle biopsy are valuable diagnostic procedures in patients with fever and elevated alkaline phosphatases of unknown aetiology. A therapeutic test with antituberculous drugs should be undertaken in suspected cases.
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PMID:Miliary tuberculosis. 39 82

From 1966 to 1973, a total of 30 cases of tuberculous peritonitis were seen in Seattle-King County. Abdominal pain, swelling, and constitutional symptoms were the most frequent initial complaints. Radiographic abnormalities consistent with tuberculosis were present in 25 cases, and pulmonary disease was proven in ten. An initial tuberculin test with intermediate-strength purified protein derivative of tuberculin was negative in 19 of 27 patients. Six of 13 initial nonreactors still had negative reactions on repeat testing, and four appeared to be anergic when retested one to four months later. Ascites was present in 67% (20) of the 30 patients, and laparotomy was used most frequently to establish the diagnosis. Diagnosis was particularly difficult in 13 alcoholics, in whom the disease was usually unsuspected, the findings in the ascitic fluid were uncharacteristic, and negative tuberculin reactions were frequent. Peritoneal tuberculosis was a contributory cause of death in five cases. Three of these patients, who were also alcoholics, went undiagnosed and untreated. Two patients died of unrelated causes. Twenty-three have done well, and 19 have completed chemotherapy.
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PMID:The spectrum of tuberculous peritonitis. 40 3

Tuberculous peritonitis is an uncommon disorder and is often not considered on initial evaluation of ascites. A negative 5-TU PPD test, a normal chest roentgenogram, or a low level of ascitic fluid protein may erroneously direct attention away from tuberculosis. Failure to thoroughly evaluate nonmalignant exudative ascites, especially in alcoholics, is a common diagnostic pitfall. TB peritonitis should be considered in the differential diagnosis in every patient who presents with ascites, fever, and abdominal pain, particularly when alcoholism, a lung lesion, weight loss, or cirrhosis is also present. Percutaneous needle biopsy of peritoneum, followed by peritoneoscopy if necessary, may preclude the need for laparotomy. Antituberculous drugs, when conscientiously taken, afford a rapid response with a cure in most patients. Case material on four patients is presented.
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PMID:Tuberculous peritonitis. 51 68

The clinical presentation and management of 30 consecutive patients with tuberculous peritonitis are reviewed. Seventy per cent of the patients were aged 40 years or less and 80 per cent were immigrants. The main clinical features of abdominal pain, loss of weight, vomiting and sweating at night had been present in a large number of patients for several months before presentation to hospital. The clinical diagnosis of tuberculous peritonitis was difficult in the absence of extraperitoneal tuberculosis. Laboratory investigations were of little value in establishing the diagnosis. An elevated ESR was found in 80 per cent of patients. At laparotomy omental biopsy was performed and was diagnostic in all cases. Laparotomy was a safe and fast method of obtaining tissue for confirmation of the diagnosis in suspected cases, particularly when presenting acutely. Ascitic fluid cultures and guinea-pig inoculations were positive in only 6 out of the 15 patients in whom they were performed. Only 1 patient died.
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PMID:Tuberculosis of the peritoneal cavity. 71 33

Between Jan. 1, 1971 and June 30, 1976 the authors diagnosed tuberculous peritonitis in 17 patients. The basis for the diagnosis was a positive culture for Mycobacterium tuberculosis from the peritoneal fluid or nodules (nine patients) or the presence of caseating granulomas in biopsy specimens of the peritoneum (eight patients). Fifteen of the 17 patients were women. Eleven were North American Indians and eight of them suffered from alcoholism. The predominant symptoms of abdominal pain, progressive abdominal distension and vomiting, and abdominal tenderness on physical examination were present both in alcoholics and in nonalcoholics. However, only the former had demonstrable ascites. The mean time from admission to hospital until establishment of the diagnosis was 8.3 days in six nonalcoholics and 49 days in the alcoholics (P less than 0.01). The delay in making the diagnosis in the patients with alcoholism resulted from a tendency to attribute their fever to alcoholic hepatitis and the ascites to portal hypertension. The mean duration of hospitalization was 160.3 days for the alcoholics and only 41.5 days for the nonalcoholics. Two of the eight alcoholics died, one of hepatic failure and the other, 3 years after the diagnosis of tuberculous peritonitis was made, of miliary tuberculosis.
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PMID:Tuberculous peritonitis in Manitoba. 73 93

The clinical course of 70 patients with tuberculous peritonitis seen over a 43 year period has been reviewed. Thirty-seven patients were diagnosed prior to the advent of anti-tuberculous chemotherapy and 33 after. Clinical manifestations remained unchanged over the period of study. Abdominal pain (93%), fever (63%), gastrointestinal upset (60%), weight loss (60%), and ascites (59%) continue to be the most common findings. Females outnumbered males 2:1. In 89% of patients the duration of symptoms prior to diagnosis was a week or longer, and in 47% it was longer than a month. Diagnosis was confirmed by histologic examination of intra-abdominal tissue in 44% of cases, by clinical suspicion with an extraperitoneal site of tuberculosis in 29%, by bacteriology of peritoneal fluid in 24%, and by autopsy alone in 3%. An extraperitoneal site of tuberculsis was present in 83% of patients. The importance of obtaining a definitive diagnosis, and of instituting immediate antimicrobial therapy is emphasized by the mortality of 49% in the pre-antibiotic era, and of 7% in patients receiving anti-microbial therapy. The conclusions from this review are that: 1) with suggestive clinical manifestations and bacteriologic proof of active tuberculosis anywhere in the patient, operation is not mandated; 2) in the presence of the above clinical manifestations, and in the absence of definitive bacteriologic proof, exploratory laparotomy is indicated for diagnostic purposes; 3) antituberculous chemotherapy is highly effective, and is the treatment of choice.
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PMID:Tuberculous peritonitis: 43 years' expereince in diagnosis and treatment. 82 25

The records of 40 patients with tuberculous peritonitis treated at Charity Hospitals in Louisiana were reviewed. Thirty-nine patients were Negroes and 24, males. The average age was 36.5 years, with 22 of the patients being between the ages of 20 and 39 years. The most common symptoms were fever, abdominal pain, weight loss and abdominal swelling. The most frequent physical signs were abdominal tenderness, fever and ascites. Diagnosis was made by laparotomy in 24, peritoneoscopy in two, paracentesis in eight, autopsy in four and upon elective hernial repair in two. Four had a previous history of extra-abdominal tuberculous, four were known to have extra-abdominal tuberculosis at the time of diagnosis and four were found to have extra-abdominal tuberculous after the diagnosis of tuberculous peritonitis had been established. The follow-up interval averaged six and one-half years. Six patients died prior to discharge, and six patients died after discharge, none of the latter deaths was established as being due to tuberculosis. Twenty-two patients were alive at the end of the follow-up interval.
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PMID:Tuberculous peritonitis. 87 Sep 99

Four patients developed miliary tuberculosis while undergoing chronic hemodialysis. Two patients had diabetes mellitus. Three of the four patients were hemodialyzed 18--24 months prior to the onset of symptoms. Signs and symptoms included prolonged fever, pleural effusion, pericarditis with pericardial effusion, abdominal pain, weight loss, and ascites. All patients were PPD negative and without historical or radiographic evidence of latent tuberculosis. Disseminated tuberculosis was proven at autopsy in three patients. M. tuberculosis was eventually recovered from pleural fluid and urine in the fourth patient. The immune deficiencies of chronic renal failure and diabetes mellitus are suspected predisposing factors to the development of miliary tuberculosis in these patients.
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PMID:Unusual presentation of tuberculosis in chronic hemodialysis patients. 89 Oct 49

The Authors review the medical records of 9 patients with liver abscess over a 15-year period from 1975 to 1989. They report on 5 pyogenic abscess, 3 amebic abscess and one case of tuberculosis of the liver. The most common initial diagnosis was fever of unknown origin, abdominal pain and hepatomegaly. The treatment consisted of 6 percutaneous transhepatic drainage, 2 open surgical drainage, and one explorative laparotomy (tbc infection). The Authors had no mortality and recommend the percutaneous transhepatic drainage as first-choice treatment.
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PMID:[Hepatic abscess]. 129 35

A 25 yr old married woman with complaints of lower abdominal pain for 2 months, was found to have a irregular nontender mass in pelvis, adherent to uterus. Her Papanicolaou smear was inflammatory. To confirm the diagnosis of either ovarian malignancy or pelvic tuberculosis made on the basis of observations during exploratory laparotomy, ovarian biopsy was taken. The imprint cytodiagnosis was tuberculosis. The patient was then managed surgically and the previous diagnosis was reconfirmed by histopathology. Imprint cytodiagnosis appears to be a valuable technique whenever facilities for frozen section are not available.
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PMID:Cytodiagnosis for pelvic tuberculosis. 130 98


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