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

Four renal allograft recipients with evidence of ischemic damage to the colon are presented and compared with 11 cases from 5 major series. Similarities in the patients included: deterioration of renal function, multiple immunosuppressive and antibiotic regimens, the use of cadaver renal allografts, and diagnostic and therapeutic measures requiring frequent enemas with barium and ion-exchange resins. Two of our patients underwent surgery for the removal of segments of necrotic colon after several weeks of fever and abdominal pain initially attributed to either acute rejection, viral infection, or pancreatitis. One patient had three days of melena and responded to non-operative therapy. The fourth patient developed ischemic colonic changes 10 weeks after allograft nephrectomy and was receiving no immunosuppression at the time. Broad spectrum antibiotics were used at various times in all patients. Early aggressive evaluation of gastrointestinal complaints--including barium enema, upper gastrointestinal series with small bowel follow-through, proctosigmoidoscopy or colonoscopy, and arteriography--is indicated, in view of the lethality of the complication of colonic ulceration. The clinical pictures presented emphasize the fact that recipients of renal allografts are commonly heir to many complications which may be considered rare in the normal population.
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PMID:Acute colitis in the renal allograft recipient. 110 14

An outbreak of severe haemorrhagic illness began in the municipality of Guanarito, Portuguesa State, Venezuela, in September, 1989. Subsequent detailed study of 15 cases confirmed the presence of a new viral disease, designated Venezuelan haemorrhagic fever. Characteristic features are fever, toxicity, headache, arthralgia, diarrhoea, conjunctivitis, pharyngitis, leucopenia, thrombocytopenia, and haemorrhagic manifestations. Other features include facial oedema, cervical lymphadenopathy, nausea/vomiting, cough, chest or abdominal pain, and convulsions. The patients ranged in age from 6 to 54 years; all were residents of rural areas in central Venezuela, and 9 died. Infection with Guanarito virus, a newly recognised arenavirus, was shown by direct culture or by serological confirmation in all cases. Epidemiological studies suggest that the disease is endemic in some rural areas of central Venezuela and that it is rodent-borne. Venezuelan haemorrhagic fever has many similarities to Lassa fever and to the arenavirus haemorrhagic fevers that occur in Argentina and Bolivia.
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PMID:Venezuelan haemorrhagic fever. 168 54

Puumala virus belongs to the hantavirus group and as other members of the group it can cause acute renal insufficiency. Other hantaviruses are responsible for Korean hemorrhagic fever and other hemorrhagic fevers with renal involvement. In Scandinavia, hantavirus nephropathy is better known as nephropathia epidemica. Hantavirus cause asymptomatic infections in mice and rats and the virus is thought to be transmitted to man via inhalation of desicated saliva, urine or feces from infected animals. In the other Nordic countries, the bank vole (Clethrionomys glareolus) is the commonest natural host. Laboratory infections from rats have been reported from all over the world. The disease presents with fever, back and/or abdominal pain, acute renal insufficiency and a bleeding tendency. The latter is usual less pronounced in the European than in the Asian forms of hantavirus infection. The disease is commoner in men and is endemic in forested areas. The greatest incidence is seen in those years when the numbers of mice are greatest. The mortality in nephropathia epidemica appears to be less than 0.5% in contrast to a mortality of about 10% in Korean hemorrhagic fever. Diagnosis is made by demonstration of a significant increase in antibody titer to hantavirus. Treatment is symptomatic and consists primarily of restitution of fluid and electrolyte balance, at times with dialysis. After recovery from hantavirus infection renal function returns to normal. The incidence and prevalence of nephropathia epidemica in Denmark are unknown. The first two cases of Puumala virus infection in Denmark are reported.
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PMID:[Nephropathia epidemica. Hantavirus and acute renal insufficiency]. 196 59

We present two patients with Hantaan virus infection, admitted to the Department of Nephrology, Skopje, at the same time, with the same clinical presentation (chills, fever, abdominal pain, hemorrhages, nausea, headache, proteinuria, hematuria, oliguria, acute renal failure) but with different pathohistological findings and different disease courses. In the first case diffuse proliferative glomerulonephritis was found, with a complete recovery of renal function after a month, with a mild proteinuria and erythruria during the second and the third month. In the second case, glomeruli were normal in general, with slight mesangial proliferation found in two out of twenty, but interstitial edema, lymphocyte infiltrations and tubular changes were noted. Complete recovery was not noted after 3 months of follow-up. The patient is now without hemodialysis treatment, with polyuria, in the stable phase of chronic renal failure which is not improving.
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PMID:Different pathohistological presentations of acute renal involvement in Hantaan virus infection: report of two cases. 198 98

Hepatoma is a rare disease in Natal Indians. It occurs in male patients in the fifth decade. They have no history of alcohol intake. The main presenting feature is abdominal pain, weight loss and hepatomegaly. Blood tests reveal a raised alkaline phosphatase, hypoalbuminaemia, hypergammaglobulinaemia and markedly raised gamma glutamyl transferase. The tumour is a single large expanding mass in the right lobe. The patient usually presents in a late stage of the illness and shows a progressive downhill course. Hepatitis B virus infection is emerging as the likeliest carcinogen.
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PMID:Hepatocellular carcinoma in South African Indians resident in Natal. 198

Clinical observation was made on 238 dengue fever cases during an epidemic in Taiwan from September to November 1988. Dengue virus infection type 1 was responsible for all cases. The majority of patients had acute onset of fever with abdominal pain, diarrhoea, and vomiting. Gastrointestinal haemorrhage with manifestation of haematemesis and/or melena was observed in 28 (11.8%) of our patients. The clinical gastrointestinal features in patients with a peptic ulcer history were not different from those in patients without it. There was no significant difference in incidence of gastrointestinal manifestations between premedication and non-premedication patients. Sixty-six non-premedication patients in our series were examined by gastroduodenoscopy. Haemorrhagic gastritis was the most common finding in 27 (40.9%) patients. The incidence of gastric and/or duodenal ulcerations was higher in patients with a peptic ulcer history compared with those without it (P less than 0.01). However, the incidence of upper gastrointestinal bleeding was similar between these two groups (19.2% vs 9.8%). Thrombocytopenia in patients with gastrointestinal haemorrhage was more prominent than in those without it (P less than 0.005). This implied that thrombocytopenia might be one of the predisposing factors for gastrointestinal haemorrhage.
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PMID:Clinical and upper gastroendoscopic features of patients with dengue virus infection. 212 43

Infectious mononucleosis is an acute viral illness associated with a high incidence of splenomegaly, although the incidence of splenic rupture is low. When rupture occurs, the mortality has been significant, presumably, because a history of trauma is not present. The spleen may be vulnerable to injury due to the histopathologic changes that occur as a result of this illness. Essentially all patients with spontaneous rupture related to infectious mononucleosis have epigastric or upper abdominal pain. The diagnosis of splenic rupture may be confirmed in a variety of ways. In those patients who are hemodynamically stable, CT scan, ultrasound, or radionuclide scan may aid in establishing the diagnosis. Selective splenic angiography is very accurate but has been largely abandoned because of the invasive nature of the study. Peritoneal lavage is efficacious in establishing the diagnosis in hemodynamically unstable patients. The treatment of choice, at this time, is splenectomy. Current interest in splenic salvage has resulted in reports of nonoperative therapy in stable patients and splenorrhaphy in one instance. Due to the extent of the histologic changes in the spleen, caution is urged in electing the conservative approach to this clinical situation.
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PMID:Splenic rupture and infectious mononucleosis. 269 60

In the ten-year period from 1978 through 1987, 261 patients with intussusception were admitted to Chang Gung Memorial Hospital. The diagnosis was established by barium enema or at laparotomy. The patients were divided into two groups; there were 228 children ranging in age from 1 month to 14 years, and 33 adults. Among the children, 134 (59%) were male and 94 (41%) were female, a ratio of 1.4:1. There was no clear seasonal incidence. The age group most commonly affected was between 3 and 11 months of age (72.4%). The classic triad of abdominal pain, vomiting, and rectal bleeding was encountered in 187 cases (82%). Two hundred one cases (88%) were idiopathic, without any definite leading point. In these cases, the ileocecal area was the site most commonly involved (82%), hypertrophic Peyer's patches of the terminal ileum being responsible for 39% of the idiopathic intussusceptions in the ileocolic area. Enlargement of the mesenteric lymph nodes occurred in 67 of the idiopathic cases (33%). Local pathology or the leading point precipitating intussusception was found in 27 cases (12%); there were eight benign tumors, six malignant tumors, and 13 tumor-like lesions. In 32 of the 33 cases in adults, there was a definite contributing pathologic entity, including 18 benign tumors, 11 malignant tumors, and three tumor-like lesions. In infants and young children, there is usually no apparent predisposing disease, and a contributing or causative local pathologic lesion is seldom found. In contrast, intussusception in adults is almost invariably caused by some preexisting lesion involving the bowel wall. Furthermore, trauma, lymphoid hyperplasia, pregnancy, and viral infection may be possible predisposing factors in the production of intussusception.
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PMID:Intussusception revisited: clinicopathologic analysis of 261 cases, with emphasis on pathogenesis. 291 50

The clinical features of 77 patients with primary liver cell carcinoma seen over a nine-year period were examined. Eighty per cent of the patients had underlying cirrhosis, of alcoholic origin in most cases. In nine of the patients hepatitis B surface antigen was found in the serum; all nine patients were born in areas where hepatitis B virus infection is endemic. Abdominal pain and ascites were the most common presenting symptoms; they are due mainly to the locally invasive nature of the tumour. A confirmatory laboratory finding in the diagnosis is the observation of raised alkaline phosphatase levels and the presence of alpha-fetoprotein in the serum. The diagnosis should be established without performing a laparotomy and should seriously be considered in a previously stable patient with cirrhosis who deteriorates clinically without obvious cause.
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PMID:Primary liver cell carcinoma. Clinical features. 396 17

Four out of 24 patients presenting as an emergency with acute non-specific abdominal pain showed serological evidence of infection with Yersinia pseudotuberculosis. Two out of 13 patients presenting with acute appendicitis during the same period also had evidence of Yersinia infection. Viral infection was present in only 1 patient in each group. Since it is rare to find antibodies to yersinia in healthy individuals, it seems likely that yersinia is a cause of some cases of non-specific abdominal pain. Viral infection does not appear to be an important aetiological factor in patients over 12 years of age.
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PMID:Yersinia and viruses in acute non-specific abdominal pain and appendicitis. 722 44


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