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

OBJECTIVE: Enterocele induces pelvic pressure, obstructed defaecation, lower abdominal pain and/or false urge to defaecate in patients. The aim of this study was to evaluate the efficacy of abdominal colporectosacropexy in these symptoms, especially on pelvic pressure. METHODS: Sixty-two consecutive women with enterocele were included. All patients were symptomatic because they had: pelvic pressure (n = 62), obstructed defaecation (n = 40), lower abdominal pain (n = 8) or faecal incontinence (n = 16). Defaecography confirmed enterocele in all patients. The surgical procedure was performed by the same surgeon and was an abdominal colporectosacropexy with a nonabsorbable Prolene(R) mesh. After surgery, clinical evaluation (62/62 patients) and a telephone questionnaire (56/62 patients) were performed, respectively, 3 months and 27 +/- 13 months after surgery. RESULTS: Defaecography showed rectal abnormalities associated with enterocele in 59/62 patients (rectocele, rectal prolapse). No recurrence of enterocele was observed 3 months after surgery, but 1 patient demonstrated recurrence 10 months after surgery. Pelvic pressure was less frequent after abdominal colporectosacropexy, than before surgery (P < 0.01): pelvic pressure totally disappeared in 41/56 patients, and partially in 10/56 patients. The number of patients with obstructed defaecation, lower abdominal pain, or faecal incontinence was not different before and 27 months after surgery. The number of patients with urinary incontinence was also not different before and after surgery (30 and 27 patients). CONCLUSIONS: This study of a large number of patients with enterocele shows that abdominal colporectosacropexy improves pelvic pressure in most patients and does not modify urinary status.
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PMID:Treatment of enterocele by abdominal colporectosacropexy - efficacy on pelvic pressure. 1278 May 75

A series of 109 female patients with urinary incontinence were treated by pelvic floor stimulation and biofeedback. Eighty-one patients received the full course of treatment and 28 patients dropped out. Among the 81 patients who completed the treatment, the improvement and cure rates (completely dry) shortly after treatment were 70.4% and 12.3%, respectively. The improvement and cure rates for more than one year after treatment were 47.6% and 14.3% respectively. Seven patients returned for further pelvic floor stimulation and biofeedback and only three patients underwent bladder neck suspension operations after completing treatment. Of the patients who dropped out, 53.6% had shown improvement with pelvic floor stimulation and biofeedback. Side effects were rare with three patients complaining of abdominal pain. These findings suggest that pelvic floor stimulation and biofeedback are useful, safe and conservative treatment modalities for female patients with urinary incontinence.
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PMID:The role of combined pelvic floor stimulation and biofeedback in female urinary incontinence: early experience. 1283 44

Retroperitoneal schwannoma is a rare tumor that originates in the neural sheath and accounts for only a small percentage of retroperitoneal tumors. Presentation is typically varied and non-specific ranging from abdominal pain, abdominal mass or an incidental finding and the diagnosis is quite often fortuitous being confirmed by anatomopathological study afterwards. We report 3 cases of benign retroperitoneal pelvic schwannoma with varied presentations. Main symptoms were abdominal and pelvic pain whereas a patient with left parailiac mass had urinary incontinence and left lower extremity pain. Surgical exploration and complete excision of tumors were successful. The histological diagnosis of the tumors was reported as benign schwannoma. All patients are doing well and had no symptoms of motor or sensory disturbances after surgery with a mean follow up of 18 mounts.
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PMID:Retroperitoneal benign schwannoma: report of three cases and analysis of clinico-radiologic findings. 1296 6

A 3-year-old boy presented at the Taiwan Adventist Hospital in Taipei with nocturnal epigastric pain and constipation. Abdominal X-ray showed colonic faecal impaction. Abdominal sonography showed gastric stasis with thickened pyloric wall and dilated rectosigmoid colons. The mouth-to-anus transit time (MATT) was prolonged. Endoscopy showed pale gastric mucosa, atony of pylorus and widening of the duodenal bulb. Three weeks after the onset of abdominal pain, he developed urinary incontinence and rapidly deteriorating paraplegia of lower limbs. Magnetic resonance imaging (MRI) showed an extradural intraspinal mass of T5-T8 and a soft tissue mass in the right superior mediastinum. After a laminectomy and tumour excision, the patient's symptoms improved quickly. The pathology revealed Burkitt's lymphoma. This is the first report of nocturnal abdominal pain and constipation as the initial manifestation of spinal Burkitt's lymphoma.
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PMID:Spinal Burkitt's lymphoma manifesting as nocturnal abdominal pain and constipation: a case report. 1456 38

OBJECTIVE: To analyze the clinical history and evolution of children and adolescents with IH, emphasizing some of their peculiar features. METHODS: We followed 471 patients with IH at an outpatient clinic. Patients were submitted to the following protocol: abdominal X-ray, kidney and urinary tract ultrasonography; urinary ionogram, blood gas and biochemical analyses; 24-hour urine for measurement of calcium and other electrolytes and creatinine; urinalysis, urine culture and phase-contrast microscopy; second morning urine collected after fasting for measurement of calcium and creatinine. RESULTS: At the time of diagnosis, 6% of the patients were infants, 15% pre-school children, 55% school children, and 24% adolescents; 56% of them were boys. Clinical and laboratory findings were: 47% had hematuria and abdominal pain, 31% had isolated hematuria, 14% isolated abdominal pain, and 8% had urinary tract infection, nocturnal enuresis, suprapubic pain or urethralgia, or the frequency/urgency syndrome with urinary incontinence. Hypercalciuria was associated with urolithiasis in 56% of patients. There was association with hyperuricosuria in 18.5% of the cases, and hypocitraturia in 8.5% of the cases. Evolution was poor for 33% of the patients, with recurrence of nephrolithiasis, persistence of hematuria, and abdominal pain. CONCLUSIONS: IH must be diagnosed and treated with criteria in order to reduce consequences such as hematuria, abdominal pain, urinary stone formation and possible bone involvement. Signs and symptoms such as urgency and urinary incontinence, suprapubic pain and nocturnal enuresis may result from renal hyperexcretion of calcium.
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PMID:[Idiopathic hypercalciuria: presentation of 471 cases] 1464 99

Trospium chloride is an orally active, quaternary ammonium compound with antimuscarinic activity. It binds specifically and with high affinity to muscarinic receptors M(1), M(2) and M(3), but not nicotinic, cholinergic receptors. It is hydrophilic and does not cross the normal blood-brain barrier in significant amounts and, therefore, has minimal central anticholinergic activity. Peak plasma trospium chloride concentrations are attained approximately 5-6 hours after oral administration, which should occur before meals as concurrent food ingestion significantly reduces trospium bioavailability. Trospium chloride undergoes negligible metabolism by the hepatic cytochrome P450 system; few metabolic drug interactions are known. While trospium chloride dosage adjustments based on age or sex appear unwarranted, such adjustments may be needed in patients with severe renal impairment. Direct comparative studies in patients with overactive bladder indicate that trospium chloride is at least as effective as oxybutynin and tolterodine. Placebo-controlled studies have also confirmed the efficacy of trospium chloride in terms of improved urodynamic parameters; small-scale, noncomparative studies have documented significant trospium chloride-induced improvements in patients with reflex neurogenic bladder, postoperative bladder irritation and radiation-induced cystitis; and observational studies including >10,000 patients have also revealed favourable findings for trospium chloride, including a marked decrease in incontinence episodes and substantial improvement in health-related quality of life. Trospium chloride is generally well tolerated, and significantly more so than immediate-release oxybutynin. The most frequent adverse events, occurring in >1% of trospium chloride-treated patients, are dry mouth, dyspepsia, constipation, abdominal pain and nausea. Available for many years in several countries outside North America, trospium chloride is likely to develop an important role in the management of overactive bladder following its approval in the US on 28 May 2004.
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PMID:Trospium chloride in the management of overactive bladder. 1548 1

After radiotherapy for pelvic cancer, chronic gastrointestinal problems may affect quality of life (QOL) in 6-78% of patients. This variation may be due to true differences in outcome in different diseases, and may also represent the inadequacy of the scales used to measure radiotherapy-induced gastrointestinal side effects. The aim of this study was to assess whether outcome measures used for nonmalignant gastrointestinal disease are useful to detect gastrointestinal morbidity after radiotherapy. Results obtained from a Vaizey Incontinence questionnaire and a modified Inflammatory Bowel Disease questionnaire (IBDQ)--both patient completed--were compared to those from a staff administered Late Effects on Normal Tissue (LENT)--Subjective, Objective, Management and Analytic (SOMA) questionnaire in patients who had completed radiotherapy for a pelvic tumour at least 3 months previously. In all, 142 consecutive patients were recruited, 72 male and 70 female, median age 66 years (range 26-90 years), a median of 27 (range 3-258) months after radiotherapy. In total, 62 had been treated for a gynaecological, 58, a urological and 22, a gastrointestinal tract tumour. Of these, 21 had undergone previous gastrointestinal surgery and seven suffered chronic gastrointestinal disorders preceding their diagnosis of cancer. The Vaizey questionnaire suggested that 27% patients were incontinent for solid stools, 35% for liquid stools and 37% could not defer defaecation for 15 min. The IBDQ suggested that 89% had developed a chronic change in bowel habit and this change significantly affected 49% patients: 44% had more frequent or looser bowel movements, 30% were troubled by abdominal pain, 30% were troubled by bloating, 28% complained of tenesmus, 27% were troubled by their accidental soiling and 20% had rectal bleeding. At least 34% suffered emotional distress and 22% impairment of social function because of their bowels. The small intestine/colon SOMA median score was 0.1538 (range 0-1) and the rectal SOMA median score was 0.1428 (range 0-1). Pearson's correlations for the IBDQ score and small intestine/colon SOMA score was -0.630 (P<0.001), IBDQ and rectum SOMA -0.616 (P<0.001), IBDQ and Vaizey scores -0.599 (P<0.001), Vaizey and small intestine/colon SOMA 0.452 (P<0.001) and Vaizey and rectum SOMA 0.760 (P<0.001). After radiotherapy for a tumour in the pelvis, half of all patients develop gastrointestinal morbidity, which affects their QOL. A modified IBDQ and Vaizey questionnaire are reliable in assessing new gastrointestinal symptoms as well as overall QOL and are much easier to use than LENT SOMA.
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PMID:A modified Inflammatory Bowel Disease questionnaire and the Vaizey Incontinence questionnaire are simple ways to identify patients with significant gastrointestinal symptoms after pelvic radiotherapy. 1585 43

Acute cholangitis is more common in older people, and increasing age is a determinant of morbidity and mortality, as is early biliary decompression by ERCP. This study aims to identify factors that may contribute to delays in the diagnosis and treatment of older people with acute cholangitis. Case notes of 122 patients (45 aged < 75 years, 77 > 75 years) with a final diagnosis of acute cholangitis who underwent ERCP were reviewed for presenting clinical features (pain, jaundice, rigors, fever, falls, incontinence, confusion), liver function tests, blood count, and the interval from admission to diagnosis, ultrasonography, and ERCP. The most common symptom at presentation was abdominal pain (81%), followed by jaundice (55%). These symptoms were no less common in older patients. Charcot's triad was present in only 15.6% of young and 18.8% of older patients. Jaundice was not detected in 16% of significantly hyperbilirubinemic older patients, but only the presence of functional symptoms was associated with significant diagnostic delay (median, 1 day [range: 0-11] vs. 9.5 days [3-25]; P< 0.001) and delay in performing ERCP (median: 4 days [0-24] vs. 16.5 days [2-29], P< 0.001). Overall mortality was 10%, and the incidence of septic shock was similar in both groups. Charcot's classical triad is infrequent in patients suffering from acute cholangitis. Given the greater difficulty assessing jaundice in older people and the confounding effect of falls, incontinence, and confusion, a routine policy of liver function tests, with further investigation of abnormal results in such presentations, may reduce delays in diagnosing and treating acute cholangitis.
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PMID:Clinical presentation and delayed treatment of cholangitis in older people. 1641 62

We describe a relatively rare case of botryoid rhabdomyosarcoma (RMS) in a 15-month-old female presenting with fever, abdominal pain, urinary retention, haematuria and a tumour protruding through the urethra. The diagnosis was verified by cystoscopy with biopsy and MRI. She was treated with combined chemotherapy and surgery. Early diagnosis and treatment are crucial to the prognosis. RMS should be considered as a differential diagnosis in cases whose symptoms include urinary retention, haematuria, urinary incontinence and atypical abdominal pain, and a primary ultrasound scan should be done. Cystoscopy and MRI should be considered, especially in cases involving atypical urological symptoms.
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PMID:[Rhabdomyosarcoma in the urogenital region of a child]. 1731 57

Inflammatory bowel disease (IBD) is a collective term for the medical conditions ulcerative colitis and Crohn's disease. Both are chronic relapsing remitting diseases with a major impact on a patient's quality of life. Symptoms of the diseases include increased bowel frequency, abdominal pain, rectal bleeding, urgency and incontinence, weight loss and reduced appetite. There is no known medical cure for either condition, and surgery often involves stoma formation and, therefore, has major implications for the patient in terms of management and body image.
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PMID:Contribution of specialist nurses in managing patients with IBD. 1736 50


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