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

Abdominal pain is a common gastrointestinal symptom in children. The purpose of this paper is to determine the upper gastrointestinal mucosal pathology in a group of children with abdominal pain. 48 consecutive children referred to the authors with the problem of abdominal pain were studied. These were divided into 2 groups. Those with only one episode of pain and lasting for less than 2 weeks were considered to have acute abdominal pain. Those with repeated episodes of pain and lasting for more than 2 weeks were considered to have recurrent abdominal pain. Careful clinical examination was done to exclude an acute surgical abdomen. Other common causes of abdominal pain in our population such as urinary tract infection, lactose intolerance, hepatitis and choledochal cyst were excluded by clinical examinations and laboratory investigations. Upper gastrointestinal endoscopy was done by one of the authors. Five out of the 16 children with acute abdominal pain had macroscopic features of acute gastritis and another 2 had duodenitis. In the other 32 children with recurrent abdominal pain, 5 had duodenal ulcers and 3 had reflux oesophagitis. It was concluded that upper gastrointestinal endoscopy was a useful means of identifying the upper gastrointestinal pathology in children with abdominal pain. 43% and 25% of the children with acute and recurrent abdominal pain respectively had a cause identified by gastroscopy.
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PMID:Upper gastrointestinal endoscopy in children with abdominal pain. 408 98

A study of bacteriuria was conducted among 426 of the 436 children under the age of 13 in a general practice in north-west London. Three girls and one boy were found to have asymptomatic bacteriuria, and a further girl with bacteriuria presented with abdominal pain and fever. The calculated incidence of urinary tract infection was 1.4% per annum. Most of the childhood urinary infections in this practice occurred before the age of 5 years, and the incidence of significant bacteriuria in this age group was 4.9% per annum. Five other children (four girls and one boy) in the practice were known to have had proved urinary tract infection. Of the total of eight children known to have had significant bacteriuria and investigated radiologically, three girls and two boys had radiological abnormalities in the urinary tract.Pyuria and proteinuria did not prove to be useful in the prediction of asymptomatic bacteriuria. Urinary tract infection with renal tract abnormality was found in this practice to be at least five times as common as diabetes in childhood.
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PMID:Study of childhood urinary tract infection in general practice. 544 Feb 35

2 case reports involving the use of steroid hormones in the treatment of pelvic infections are presented. The first was a young woman with bilateral salpingo-oophoritis. The patient continued to have low abdominal and pelvic pain and to remain febrile following closure of the posterior cul-de-sac and antibiotic therapy. 2 days after cortisone was added to the treatment the patient was afebrile and after 5 days she was discharged and received diminishing doses of corticosteroid. The second case involved a young married woman with acute salpingo-oophoritis who suffered recurring episodes of salpingitis and urinary tract infection and continued to have disabling abdominal pain, especially with her menses. The infection was treated with sulfasoxisole, and menstruation was suppressed with medroxyprogesterone for 1 year. At the time of writing she had been menstruating regularly for 8 months and was free of abdominopelvic pain.
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PMID:Two unusual uses of steroid hoones in pelvic infections. 579 36

In 1979, the North Carolina Medical Care Commission approved the performance of laparoscopic sterilizations in free-standing surgical facilities. This paper reports the 1st 101 laparoscopic sterilizations performed at the Crist Clinic in Jacksonville. The majority of patients were white, married, and receiving medical assistance. Median age was 30, and median number of children was 2. 36 women had been using oral contraception, 10 were IUD acceptors, 23 had been using other methods, and 32 had been using no contraception. Surgery averaged 28 minutes. The recovery time after surgery averaged 86 minutes; however, 16 women left within 1 hour and only 12 required 2 or more hours of observation. Operative complications occurred in 3 cases. There was 1 failed trocar insertion and 1 loose clip. The 3rd complication observed, extrusion of omentum and vaginal bleeding, was noted in a combined midtrimester abortion-sterilization procedure. Postoperatively, 3 patients complained of superficial wound infection, 2 of abdominal pain, and 1 of heavy bleeding. 6 women developed vaginitis and there was 1 urinary tract infection. However, none of these complications required hospitalization. 3 pregnancies were detected after the procedure, 1 of which existed at the time of tubal ligation. Total costs of the procedure in this free-standing facility were 30-45% those of a hospital, reflecting savings in room and board, anesthesiology, and operating room fees. It is estimated that if half of the women seeking laparoscopic sterilization were to have the procedure performed in a free-standing facility, the annual savings would be more than $70 million. There is no evidence that the cost reductions achieved with this series were at the expense of increased risk of medical complications. The only serious complication involved a midtrimester abortion-sterilization procedure, leading to the recommendation that sterilization be postponed to 4-6 weeks after evacuation. It is further suggested that physicians perform at least 200 laparoscopies, including 100 under local anesthesia in an operating room with back-up anesthesia, before attempting this procedure in a free-standing facility. Such experience gives physicians skills and the judgment required to select appropriate low risk patients.
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PMID:Laparoscopic clip sterilization in a free-standing facility: an evaluation of cost and safety. 622 79

In 259 subjects at risk to have inherited autosomal dominant polycystic kidney disease (PKD), the frequency of symptoms consistent with urinary tract infection, haematuria, back and abdominal pain, hypertension, renal stones, and end-stage renal failure was evaluated. The diagnosis of PKD was made in 140 of these subjects (54 per cent). At the time of the study, 36 per cent of males and 7 per cent of females with PKD were asymptomatic, normotensive, and denied any previous problems. In patients younger than 30 years, 66 per cent of males but only 11 per cent of females were asymptomatic. In female patients, urinary tract infection (69 per cent) and hypertension (61 per cent) were the most frequent clinical manifestations. In contrast, in males with PKD, these problems were present in only 19 per cent and 42 per cent, respectively. Frequency of other clinical manifestations was similar in women and men with PKD. End-stage renal failure was present in 5 per cent of the 81 patients younger than age of 40, in 33 per cent of the 27 patients 40-49 years old, and in 47 per cent of the 32 patients aged 50 years or more. Physical examination was unreliable in estimating kidney size in most patients, particularly in early stages of the disease. Hypertension and symptoms such as haematuria and back pain, but not urinary tract infections, correlated well with renal size measured by radiograms.
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PMID:Autosomal dominant polycystic kidney disease: symptoms and clinical findings. 624 69

Fifty-eight patients seen in general practice presenting with symptoms of acute urinary tract infection were entered consecutively into an open randomized trial of 200 mg pivmecillinam plus 250 mg pivampicillin twice daily or 250 mg amoxycillin plus 125 mg clavulanate 3-times daily for 5 days. The results were analyzed in 41 patients with significant bacteriuria (23 on pivmecillinam/pivampicillin and 18 on amoxycillin/clavulanate). Both antibiotic combinations produced good overall bacteriological cure, but there were a considerable number of persisting symptoms despite the absence of significant bacteriuria. Eight patients in the pivmecillinam/pivampicillin group and 5 in the amoxycillin/clavulanate group had side-effects, principally thrush, vomiting and abdominal pain, and 1 patient from each group ceased treatment for this reason. Sensitivity profiles of urinary isolates (41 trial, 135 non-trial) to both combinations and to ampicillin and mecillinam showed that the majority were fully sensitive to amoxycillin/clavulanate and to a lesser extent to pivmecillinam/pivampicillin; resistance was highest to ampicillin.
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PMID:A comparative trial of pivmecillinam/pivampicillin and amoxycillin/clavulanate in the therapy of urinary tract infection in a general practice population. 639 34

Xanthogranulomatous pyelonephritis (X.G.P.) is a rare unilateral manifestation of chronic interstitial nephritis. 4 new cases of X.G.P. in children are reported. The authors review 60 cases of the literature since 1963. The X.G.P. has no predominant sex distribution. The age extended especially between 1 to 5 years. The diffuse type is more common in boys, and the localized type in girls. The clinical signs : fever, abdominal pain, weight loss, urinary infection, abdominal mass. Proteus Mirabilis is the main organism in the diffuse form and Escherichia Coli in the focal form. Actually, the disease is often diagnosed before surgery. The treatment is always nephrectomy and the prognosis is very good (benign). The final diagnosis of X.G.P. can only be made by histological examination. Etiopathogenesis remains obscure : urinary tract infection and obstruction, arterial and veinous lesions, local immunity deficiency.
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PMID:[Xanthogranulomatous pyelonephritis in children. Report of 4 cases]. 642 3

In 64 children (age 1-15, mean 7.3 years) with unilateral idiopathic hydronephrosis, measurements were made of glomerular filtration rate (GFR), separate glomerular filtration rate (SGFR, measured as 51Cr-EDTA clearance combined with renography) and renal concentrating capacity. Onset symptoms were urinary tract infection in 34 children and abdominal pain in 25, while 5 were asymptomatic. Surgery was performed soon after the first investigation in 34 children and during the follow-up period in 14, and 16 children received only conservative treatment. The mean follow-up time was 4.4 years. At the time of diagnosis the total GFR and the SGFR of the affected kidney were normal or almost normal in all the children (respective means 108 +/- 16 and 50 +/- 12 ml min-1 X 1.73 m2(-1)). The total GFR remained normal at follow-up, but SGFR became subnormal in two conservatively and two surgically treated children. The concentrating capacity was initially lower in the children with, than in those without urinary tract infection. The former values had increased significantly at follow-up examination. The study indicates that the parenchymal function in unilateral idiopathic hydronephrosis in children more than 1 year old usually is normal, but may deteriorate due to urinary tract infection. Such infection should be carefully searched for and treated. Since very few of these children seem to have pelvic obstruction, surgery seldom is primarily necessary.
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PMID:Renal function in idiopathic hydronephrosis in children. Follow-up after conservative and surgical treatment. 646 97

An unusual case of pelvic abscess characterized by a relatively mild clinical course and unusual localization occurred in a previously healthy, married, 26-year old woman with 2 children and 1 previous abortion. The woman was admitted to the hospital for lower abdominal pain of 1 week's duration. A Lippes Loop C inserted 5 years earlier, 4 months after a term delivery, had caused no complications. The last menstrual period was 2 weeks before admission. 1 week before admission lower abdominal cramps and dysuria had started, and nitrofurantoin 400 mg daily was prescribed for suspected urinary tract infection. The patient was hospitalized when the pain worsened. The patient appeared well on admission. Abdominal examination disclosed a very tender suprapubic mass the size of a 14-week pregnancy. Vaginal examination revealed an anterior, normal-sized uterus adherent to the mass. An examination under general anesthesia revealed a 12 cm mass adherent to a normal sized uterus. Multiple adhesions prevented visualization of the pelvic organs during laparoscopy. The IUD was removed and sent for bacteriologic examination. Laparotomy revealed a mass with a diameter of 10 cm located between the bladder and the uterus and adherent to them and to the anterior abdominal wall. The tubes were hyperemic and edematous, and pus was noted in both fimbriae. Both ovaries appeared normal. The mass was excised and a frozen section examination established the diagnosis of an abscess, which was later confirmed by histopathologic examination. A course of intravenous gentamycin, ampicillin, and clindamycin was started. Polymicrobial infection with Streptococcus viridans, Staphylococcus, coagulase negative, and diptheroids was subsequently established. The postoperative course was uneventful, and physical examination a month later was normal. No explanation of the unusual location of the abscess in the visicouterine space or of the absence of most of the symptoms of an abscess was found.
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PMID:Pelvic abscess associated with a Lippes loop. An unusual case. 663 39

A series of 161 hydronephrotic kidneys from a 30-year period in 147 children is reported. The left kidney was affected more frequently than the right and the condition was more common in the male than in the female child. In infants, abdominal mass was a common mode of presentation. In older children, loin or abdominal pain, haematuria and urinary tract infection were typical findings. The principles of treatment have changed: during 3 decades there has been a definite shift from nephrectomy to dismembered pyeloplasty, mostly according to Anderson-Hynes technique or its modifications. The results of the dismembered pyeloplasties were good or excellent as contrasted with often unsatisfactory results of the non-dismembered pyeloplasties. There were 1 early and 1 late death in the series; both of these patients were uraemic already preoperatively. The key to good results is the dismembered pyeloplasty with postoperative nephrostomy drainage and applying a stent for the anastomosis, combined with strict control of postoperative pyelonephritis.
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PMID:Pelviureteric obstruction in children. 663 1


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