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

Volvulus of the sigmoid colon is a common cause of colonic obstruction in many parts of the world, mainly in developing countries and in Scandinavia, but is rare in the Western Hemisphere, where it occurs in elderly patients who often have serious coexisting diseases, especially cardiovascular and neuropsychiatric disorders. Although many patients present with the typical triad of abdominal pain, distension and constipation, the disease is correctly diagnosed only in about 62%. Diagnostic delay is due in part to the relative rarity of the illness, in part to the variety of the clinical and radiologic presentation, and it might contribute to the high mortality. Treatment consists in endoscopic decompression, whenever there are no compromised intestines, followed by an elective, sigmoid resection in otherwise healthy patients, because the risk of recurrence is high after nonoperative decompression alone. Hartmann's procedure is the safest procedure in patients with ischemic necrosis of the sigmoid colon. The site of primary resection and anastomosis with viable bowel remains controversial. Knowledge of sigmoid volvulus is of general interest with respect to the growing number of elderly patients, especially those residing in nursing homes and psychiatric institutions.
 ...
PMID:[Sigmoid volvulus--clinical, radiological and therapeutic aspects of rare disease]. 763 Oct 98

Exploratory laparotomy of an adult dairy cow, examined because of acute signs of persistent abdominal pain, revealed a firm pulsatile mass with associated fremitus just distal to the origin of the cranial mesenteric artery. The cow died acutely 2.5 days after surgery. A dilated, thin-walled, sacculated aneurysm, which had ruptured, was located along the proximal portion of the cranial mesenteric artery. It was postulated that the aneurysm developed secondary to structural defects in the arterial wall, but caused no clinical signs until enlargement and local tissue stretching or circulatory disturbances caused intestinal ischemia, resulting in abdominal pain. Aneurysms of visceral arteries in cattle should be considered as another differential diagnosis for signs of abdominal pain after more common causes such as severe bloat, mesenteric root volvulus, intussusception, cecal dilatation/volvulus, and uterine torsion have been excluded.
 ...
PMID:Aneurysm of the cranial mesenteric artery in a cow. 764 80

An 83-year-old woman, largely bedridden since a stroke 2 years before, was hospitalized because of upper abdominal pain, nausea and obstipation. She had regularly been taking laxatives of the anthraquinone type. She had a fever of 38.6 degrees C and leukocytosis (14,900/microliters). Radiological examination revealed volvulus of the sigmoid colon with ileus. As she vehemently refused an operation, it was attempted to reduce the volvulus endoscopically. At the first coloscopy the volvulus was untwisted. At that time there were already areas of necrosis in the rectosigmoid and descending sigmoid portions. As the volvulus recurred three days later, another coloscopic derotation was performed, this time with fixation of the sigmoid by three gastrostomy tubes for 20 days. The further course was uncomplicated, the patient had regular bowel movements and became free of fever and symptoms. The white cell count returned to normal and the intestinal mucosa healed histologically without scarring. There has been no recurrence for 10 months. The conventional treatment of volvulus of the sigmoid is decompression followed by sigmoid resection. This case describes for the first time the nonoperative treatment by percutaneous endoscopic colopexy.
 ...
PMID:[Percutaneous endoscopic colopexy--a new treatment possibility for volvulus of the sigmoid]. 771 43

Malrotation in the neonate is an anomaly for which there are clear indications for surgery. However, the management of the older patient with this entity is not well defined. At Arkansas Children's Hospital, we reviewed our patients who were older than two years of age with malrotation. Between 1978 and 1993, 22 cases ages 2-23 years were identified. The most common presenting symptoms were vomiting 15 (68%), colicky abdominal pain 12 (55%), and diarrhea 2 (9%). Other symptoms were hematemesis 1 (5%), and constipation 1 (5%). The duration of symptoms averaged 28 months, range 2-96 months. All diagnoses were made by upper gastrointestinal (UGI) series, except for one that was recognized during an exploratory laparotomy for an intestinal duplication. A Ladd's procedure with appendectomy was performed in all cases. A significant number of patients in our series (41%) were found to have either a volvulus or internal hernia at exploration that was not clearly demonstrated by the diagnostic studies. Intestinal resection was performed in two patients for ischemic bowel. There were no perioperative deaths. Postoperative complications consisted of a wound infection in one patient. Total relief of symptoms occurred in 64% of patients. All patients with volvulus or internal hernia had resolution of symptoms, and all patients reported partial relief of their chronic symptoms. Surgical therapy eliminates the possibility of loss of bowel from volvulus or internal hernia, which is not always evident on diagnostic radiographic examination. Surgery is also highly effective in alleviating the chronic symptoms in these children. We believe, therefore, that surgical treatment is clearly indicated in the older child with proven malrotation.
 ...
PMID:Malrotation in the older child: surgical management, treatment, and outcome. 785 73

A 72-year-old woman had been experiencing upper abdominal pain and vomiting for 2 years. On physical examination the abdomen was swollen and pressure sensitive. She had a leukocytosis (11,400/microliter) and hypokalaemia (3.6 mmol/l). X-ray films of the chest and abdomen revealed a large gastric air-bubble with two fluid levels of different height and an elevated left diaphragm, findings which suggested gastric volvulus. Most of the fluid was evacuated via a nasogastric tube. The stomach interior was difficult to examine by gastroscopy: it was only after withdrawal of the gastroscope from the duodenum that a normal gastric architecture was demonstrated, the volvulus apparently having been reduced during the gastroscopy. The gastric mucosa showed ulcerations and erosions. Gastropexy by gluing together the peritoneal layers was undertaken via dual percutaneous endoscopic gastrostomy. The catheters were removed after 4 weeks when the ulcerations had healed. The patient has been free of symptoms for more than a year so far.
 ...
PMID:[Treatment of an intermittent stomach volvulus using gastropexy via percutaneous endoscopic gastrostomy]. 798 66

The case of an 11-year-old girl with a history of chondrodysplasia punctata is reported. She presented with a clinical picture of abdominal pain and vomiting. At surgical intervention an organo-axial gastric volvulus was found and a single derotation was performed. Three weeks after discharge the patient presented abdominal distension and vomiting. In a plain abdominal X-ray film a gastric dilation was appreciated and a new volvulus was detected by means of a contrast radiogram. The diagnosis was confirmed at surgery and a gastropexy was performed without volvulus relapse.
 ...
PMID:[Stomach volvulus in a female patient with chondrodysplasia punctata]. 799 20

The definition of volvulus is an axial twist of a portion of the gastrointestinal tract along its mesentery. The involved bowel is obstructed partially or completely with a variable degree of arterial and venous occlusion. The colon is the most common site for volvulus. The splenic flexure is the least common site of colonic volvulus. We experienced a case of the volvulus of the splenic flexure. It will be the 30th case of the volvulus involving the splenic flexure in the English literature, to our knowledge. A 30-year-old woman was admitted due to abdominal pain and distention with vomiting. An emergency barium study revealed characteristic "bird beak" sign. Surgery was performed resecting the involved colon of splenic flexure. The result was excellent.
 ...
PMID:Volvulus of the splenic flexure of the colon. 800 3

In order to examine the presentation and course of Crohn's disease (CD) versus those of ulcerative colitis (UC) in children < or = 10 years of age, a retrospective review of children < or = 10 years old with inflammatory bowel disease singled out 40 patients and compared their findings with those of 38 children with UC. The mean age at onset was 7.5 years for CD, as compared with 5.9 years for UC. A family history of inflammatory bowel disease was present in 13 patients (32%). Abdominal pain (97%), diarrhea (78%), and weight loss (88%) were the major initial complaints, with growth retardation present in 12 (30%) children. At onset, four children had diffuse small-bowel disease, nine had terminal ileal disease, 15 had ileocolitis, and 12 had colitis; at the end of the study two had diffuse small-bowel disease, four had terminal ileal disease, 25 had ileocolitis, and seven had colitis. Extra-intestinal manifestations increased with duration of disease. Although the number of recurrences did not differ greatly between groups, those with ileocolitis and colitis needed longer steroid therapy and more days in hospital than did those with only small-bowel disease. Operation was required in 42.5% of children with CD, as compared with 5% of those with UC, with six CD children (35%) requiring later reoperation for recurrent disease or fistula and abscess. Two children died from causes unrelated to their disease (gastric volvulus, carcinoma of the breast).(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Crohn's disease in children 10 years old and younger: comparison with ulcerative colitis. 857 7

A 61-yr-old women presented with vomiting, abdominal pain, and distention. Nasogastric and endoscopic decompression failed to relieve her distention. Radiographic studies suggested gastric necrosis without other pathology. Laparotomy revealed a rare form of mesenteroaxial volvulus of the fundus with frank necrosis. The patient underwent gastric resection with anterior gastropexy followed by an uncomplicated postoperative course. This paper discusses the etiology, anatomic definition, and therapeutic options in patients with acute gastric volvulus.
 ...
PMID:Acute gastric volvulus: pathogenesis, diagnosis, and treatment. 821 25

The syndrome of degenerative leiomyopathy causing intestinal obstruction clinically manifests in young indigenous African children as massive megacolon without aganglionosis. Eighteen children have been seen over a 16 year period from a localized geographic area. There were 10 males and 8 females having a mean age of 9.5 years at presentation and a mean duration of symptoms of 4.3 years. The youngest was 6 months old. All had progressive abdominal distension and infrequent stooling but 11 had intermittent diarrhoea and 9 had colicky abdominal pain. Gross gaseous distension of the large bowel with extension into small intestine occurred in 9 and this extended into stomach and oesophagus in 4. Biopsy of the dilated, thin walled bowel showed smooth muscle degeneration and necrosis with replacement by fibrous tissue. Neuronal cells of Auerbach's plexus tend to be displaced into the circular layer of smooth muscle with mild inflammatory changes. Some small arteries show medial fibrosis with subintimal fibroblastic proliferation. Acetylcholinesterase and immunohistochemical staining with neural and muscle markers are within normal limits. One child died while 14 have been maintained on prokinetic agents, low residue diets, laxatives and enemas. Nine children have required surgical intervention of whom 4 had volvulus and 3 adhesive bowel obstruction. Degenerative leiomyopathy is a distinctive entity with classical clinical and histological features. The aetiology is still obscure.
 ...
PMID:Degenerative leiomyopathy in African children: a review of current perspectives. 822 9


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>