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

A mobile caecum can certainly exist perpetually without symptoms. The operation is indicated after a barium enema and upper gastro-intestinal x-ray examination if the symptoms-especially colicky abdominal pain-have been lasting for a long period. Caecum and ascending colon are fixed at the lateral abdominal wall as a "coecocolofixatio lateralis" (Klose 1909). 93.7% of our 35 patients had no postoperative complaints. The operation is not indicated as prophylaxis for volvulus or invagination.
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PMID:[The mobile-cecum--a contribution to the independence of this disease and to its surgical treatment]. 675 60

One is tempted to believe that volvulus in elderly patients on many occasions may be preceded by inactivity and pseudomegacolon. Owing to psychiatric problems, chronic illness, or institutionalization, the patient is more likely to be subjected to treatment with sedatives and psychotropic drugs, causing decreased neuromuscular function of the gut. The basic principles in treating the volvulus are releasing the volvulus, deciding whether a nonoperative or an operative procedure should be employed, and treating complications. As far as surgical management is concerned, several techniques have been suggested, some of which are still controversial. Colonoscopy appears to have become an important method of treatment for volvulus with clearly established indications. Oddly enough, already hospitalized patients are occasionally subjected to delayed attention for volvulus. Therefore, physicians responsible for the care of geriatric patients should be alerted by even fairly mild symptoms of distention, abdominal pain, vomiting, and constipation. Clinical evaluation, including routine films of the abdomen, may avert a major catastrophe.
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PMID:Colon volvulus and the geriatric patient. 707 92

The most common cause of colonic obstruction is adenocarcinoma, followed by diverticulitis, volvulus, and a variety of miscellaneous causes. Most signs and symptoms, from whatever cause, consist of abdominal pain with distention and the inability to pass flatus or stool. The clinical diagnosis is confirmed by x-ray studies. Plain films of the abdomen in various positions, chest films, and the addition of contrast studies verify the cause of the obstruction in most instances. The differentiation between neoplasm and diverticulitis causing the obstruction can be difficult or impossible at times, and may become apparent only after the obstruction begins to resolve with conservative management, or the cause is discovered at surgery. The history of previous abdominal or pelvic irradiation, surgery, and inflammatory bowel disease often causes difficulty in the differential diagnosis.
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PMID:The diagnosis of colonic obstruction. 711 69

For a period of four years, five adult patients with nonrotation of the intestine and midgut volvulus have been treated. Two distinct clinical presentations were encountered. The chronic presentation is that of colicky abdominal pain, often present for many years, which is corrected by surgical intervention. The acute presentation with strangulation of the intestine may occur without pre-existing symptoms. Knowledge of this entity and a high index of suspicion are necessary for the diagnosis because massive gangrene of the intestine may result from a delay in treatment. Prophylactic surgical treatment in the asymptomatic patient is recommended to prevent this catastrophic occurrence.
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PMID:Surgical treatment of midgut nonrotation in the adult patient. 720 63

The origin of increased alkaline phosphatase (ALP) activity in peritoneal fluid (PF) of horses with clinical signs of abdominal pain was investigated to determine the usefulness of measuring ALP in PF in the diagnosis of small intestinal injury. The ALP isoenzymes in PF from 10 clinically normal horses and from 50 horses with clinical signs of acute abdominal pain were analyzed for their sensitivities to inhibition by L-phenylalanine, L-homoarginine, and levamisole and to inactivation by heat (56 C, 15 minutes). The enzymes also were discriminated by their patterns of migration during polyacrylamide gel disc electrophoresis. Of 50 horses with colic, 20 had ALP activity in PF at least 3 times the upper limit of normal. Of these 20 horses, 10 had marked increases of ALP activity in PF ranging from 10 to 150 times the mean value of activity as determined in the 10 normal horses. In the 50 horses with colic, ALP values in serum were within the normal range. In 19 of the 20 sick horses, the ALP in PF had properties different from small intestinal ALP. Of the 10 PF samples with markedly increased ALP activity, 9 had a group of properties that were unique for granulocytic ALP. The clinical diagnoses for the 10 horses with markedly increased ALP activity in PF included thromboembolic colic (4 horses), colonic torsion (2 horses), small intestinal volvulus (2 horses), peritonitis (1 horse), and salmonellosis (1 horse). Properties of the enzyme in the 10 PF samples with moderately increased ALP activity were compatible with a granulocytic origin, but insufficient enzyme concentration precluded electrophoretic confirmation of the source. The PF from 1 horse had a mixture of ALP isoenzymes derived from granulocytes and small intestinal mucosa. Of the 50 horses with colic, 6 had severe small intestinal disease without increased ALP activity in PF. Apparently, increased ALP activity in PF cannot be used as a reliable indicator of small intestinal injury in horses, because the ALP is predominantly granulocytic in origin.
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PMID:Origin an importance of increased alkaline phosphatase activity in peritoneal fluids of horses with colic. 725 13

Surgery was performed on a rare case of incarcerated Chilaiditi's syndrome, a syndrome that has been known for 10 years. The patient was in the state of ileus with volvulus of the stomach and hepatodiaphragmatic interposition of the stomach, transverse colon, and omentum majus. The patient was at high risk--77 years old and in bad condition due to hyperemesis and abdominal pain. Preoperative intensive care was necessary. During the operation the intestinal structures were repositioned, the diaphragmatic hernia was resected, and the muscular parts were sewn tight. The right position of the liver was reconstructed by sewing the ligaments. Colon resection was inevitable because the colon loop could not be separated and because there was lack of intraabdominal space. For indication of preventive and elective surgery, we propose that the diagnostics be enhanced when Chilaiditi's syndrome is found by chance and is still asymptomatic. These techniques may include a complete radiological examination with contrast medium, intestinal endoscopy, and computer tomography of the thoracoabdominal region.
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PMID:[Incarcerated Chilaiditi disease. A rare indication for surgery]. 726 6

Malrotation in the adult can mimic acute appendicitis. A complete abdominal exploration is needed to find any obstructing bands or midgut volvulus. The difference between mixed rotation, which usually presents with midgut voluvlus and or duodenal obstruction, and nonrotation, which is usually asymptomatic or presents with intermittent attacks of abdominal pain, is stressed. Therapy is recommended according to the type of defect present.
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PMID:Anomalies of gut rotation mimicking appendicitis in the adult. 738 85

Seventy-four patients were operated on at Childrens Hospital of Los Angeles between 1951 and 1977 for abnormalities of intestinal rotation with or without volvulus. The mortality in this group of patients was 4% and represents a significant improvement from the 23% mortality previously reported from this institution between 1937 and 1951. Neonatal patients had bilious vomiting and signs of high intestinal obstruction while older children had a more chronic course characterized by intermittent episodes of abdominal pain. Evaluation with contrast studies and early celiotomy is mandatory to prevent bowel necrosis. We outline the associated gastrointestinal anomalies and management of these combined anomalies.
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PMID:Malrotation of the midgut in infants and children: a 25-year review. 746 43

The records of 54 pediatric patients with symptomatic malrotation of the intestine seen over a 15-year period from 1978 to 1992 were reviewed. Bilious vomiting and bloody stools were the two most common clinical presentations in neonates, while bilious vomiting, recurrent abdominal pain and failure to thrive were the most common symptoms after the newborn period. Obscure symptoms, usually of appreciable duration, were common in many patients beyond infancy. Upper gastrointestinal radiologic examination is the preferred and more accurate method of diagnosing malrotation as it has greater sensitivity than barium enema study. Laparotomy showed 24 cases with midgut volvulus. The incidence of midgut volvulus in symptomatic malrotation was 42.1% in the neonatal period, and 50% beyond the neonatal period. The majority of patients were treated by Ladd's operation. Massive gangrene of the small bowel due to volvulus was noted in five neonatal cases. Three patients subsequently died of this complication. Four patients developed a bowel obstruction secondary to adhesions, which was relieved by enterolysis. This study reiterates that newborns with symptomatic malrotation require emergency laparotomy in order to prevent catastrophic massive bowel resection.
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PMID:Intestinal malrotation and midgut volvulus: a 15-year review. 760 79

A 14-year-old Thoroughbred broodmare was evaluated for signs of mild to moderate abdominal pain of 5 hours' duration. Exploratory celiotomy revealed a 20 x 8-cm subserosal hematoma associated with a focal serosal perforation overlying a muscular tear along the parietal surface of the stomach. The odor of intestinal tract gas was detected, but gross contamination of the abdomen was not evident. Concurrent partial volvulus of the small intestine was evident. Removal of the large colon from the abdomen appeared to coincide with propagation of the serosal perforation to a full-thickness gastric rent. The tear was repaired by use of a 2-layer inverting closure. The horse had evidence of an acute gastrointestinal tract hemorrhage 10 days after surgery, but responded to treatment. At a 2-year follow-up evaluation, the mare had foaled once and had not experienced recurrent signs of abdominal disease.
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PMID:Repair of a full-thickness gastric rupture in a horse. 755 1


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