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

Non-specific abdominal pain (NSAP) is a well-recognized clinical problem which places a significant burden on health resources. We studied 100 premenopausal women who were admitted consecutively through the Accident and Emergency Department of the Mater Misericordiae Hospital to assess final diagnosis, duration of hospital stay, extent of investigation, recurrence of symptoms and final diagnosis. The patients were placed in the following diagnostic categories: Gynaecological (30%), Renal (9%), Acute appendicitis (23%), Miscellaneous (9%) and Non-specific abdominal pain which accounted for 29% of the admissions. The mean duration of hospital stay for patients with NSAP was 67 days, one third underwent specialized investigations and one third underwent appendicectomies for normal appendices. On review, one year after admission, 66% of patients admitted with NSAP were asymptomatic.
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PMID:Non-specific abdominal pain in pre-menopausal women. 142 61

Mesenteric cysts are rare intraabdominal lesions of childhood that may vary in presentation from an asymptomatic mass to an acute abdomen. From 1970 to 1990, 15 children were diagnosed and treated for mesenteric cysts at Ste Justine Hospital in Montreal. The ages ranged from birth to 18 years (average age, 6 years). There were 9 boys and 6 girls. Ten patients required emergency surgery and five underwent elective surgery. The main presenting symptom was abdominal pain. Ten patients had preoperative ultrasounds that were diagnostic for a cystic mass in all patients. The second most frequent preoperative diagnosis was appendicitis. The cysts were located in the small bowel mesentery in 5 cases, the base of the mesentery with retroperitoneal extension in 4 cases, the transverse mesocolon in 4 cases, and the gastrocolic ligament in 2 cases. Operative procedures performed included complete cyst excision (9 patients), complete excision with intestinal resection (5 patients), and drainage of the cyst (1 patient). The only recurrence in this series occurred after drainage. One other patient had recurrence of a mesenteric cyst following resection performed elsewhere. Mesenteric cysts are rare in children, are usually symptomatic, and are most commonly misdiagnosed as acute appendicitis. Accurate preoperative diagnosis is possible with current ultrasonographic imaging techniques. Complete cyst resection is the procedure of choice and results in an excellent outcome.
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PMID:Mesenteric cysts in children. 181 63

Seventeen girls were treated following the diagnosis of ovarian cysts. Four patients were operated on within the first 6 months of age and the other 13 patients were 10-15 years old at the time of diagnosis. Antenatal diagnosis was made in 3 cases. The presenting symptoms in the infants were distended abdomen in 3 cases, abdominal pain in 1 and vomiting in 1. In the older children the presenting symptoms were abdominal pain in 12, vomiting in 5 and elevated temperature in 6. Preoperative ultrasound was performed in 5 patients, 3 neonates and 2 older children. Sixteen of the 17 girls were operated on. The indication for surgery was an ovarian cyst with complication in the infants and in the older children the suspicion of acute appendicitis. The operative procedure was cyst uncapping in 7 cases, salpingo-oophorectomy in 4, ovarian resection in 2, ovarian fixation only in 1 and no ovarian intervention in 2. Asymptomatic infants with an ovarian cyst less than 4 cm in diameter can be managed conservatively. Surgery can be recommended after documented change of the cyst on ultrasound, large cysts giving rise to symptoms or presentation of an acute abdomen. Salvage of variable ovarian tissue is desirable.
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PMID:Diagnosis and treatment of ovarian cysts in children. 188 16

The analysis of case records of 19,966 children operated on for acute appendicitis at the Belorussian centre of pediatric surgery for 15 years (from 1970 till 1984) is presented. In 2796 (14%) children, the atypical location of the vermiform process was diagnosed at operation. In atypical location of the vermiform process, the clinical manifestations of acute appendicitis differ from those in its common location: abdominal pain is most frequently (47.8% of cases) localized outside the inguinal region, less often, tensity of the anterior abdominal wall muscles, symptoms of peritoneal irritation are noted. Children with acute appendicitis in atypical location of the vermiform process twice later (when compared with patients with its typical location) are admitted to the hospital, and as well twice longer are observed before the operation. The incidence of complications after the operation is more than two-fold greater.
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PMID:[Acute appendicitis in children with atypical location of the vermiform process]. 194 97

The clinicopathological features of schistosomiasis of the appendix are discussed, based on the clinical presentation, operative findings and morphological changes in the specimens of patients seen in Ibadan between 1980 and 1989. Schistosoma haematobium was implicated as the causal agent of a granulomatous inflammatory reaction with eosinophilia and fibrosis. Intramuscular oviposition was associated with frank acute appendicitis, and serosal involvement resulted in peritoneal adhesions, with ileoileal intussusception in one patient. The actual role of schistosomal infestation as a contributory factor in appendicitis is still open to debate, but the diagnosis must be entertained in patients in the tropics with features of acute appendicitis or recurrent abdominal pain.
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PMID:Schistosomiasis of the appendix. 195 89

In the last nine years we have operated upon six children (eight males and two females) with primary omental pathology. The age of our patients ranged from five to eleven years with the exception of a newborn prenatally diagnosed of lymphangioma. All the remaining children had abdominal pain and right iliac tenderness for an average of two days. All had leukocytosis and left shift. Vomiting and fever were present only in one instance. In no case the mass was palpated preoperatively. The initial diagnosis was acute appendicitis in all cases. A patient suffered, one year after operation, a second acute clinical picture and the omental mass could be revealed [correction of decealed] preoperatively. At operation there was free intraperitoneal fluid in six instances (three times bloody, two times clear and one purulent). Surgical findings (nine operations) were: three omental segmental infarctions (primary in two cases and secondary to torsion in one), three segmental epiploitis in two patients (one acute, one chronic, one secondary to foreign body), two cystic lesions (one lymphangioma, one hydatic cyst) and one benign tumor (fibromatosis).
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PMID:[Primary surgical pathology of the epiploon]. 209 40

Four cases of diabetic ketoacidosis presenting with abdominal pain are reported. Case 1: a 14-year-old boy suffered from sudden onset of mid-abdominal pain, then migrating to the right lower quadrant. Nausea and vomiting occurred subsequently. Appendectomy was performed under the impression of acute appendicitis in an outside surgical clinic. The patient became comatose the next day and then was transferred to our hospital. Diabetic ketoacidosis was diagnosed after the detection of hyperglycemia, glycosuria, and ketonuria on the day of admission. Unfortunately, he expired on the same day in spite of vigorous resuscitation. Case 2: a 9-year-old boy complained of abdominal pain for 10 days. There was no specific finding in the physical examination. Diabetic ketoacidosis was confirmed four days later when conscious disturbance, dehydration, and tachypnea were noticed. Case 3: a 10-year-old girl presented with a history of intermittent abdominal pain for one month. The character of the abdominal pain was nonspecific. Glycosuria was detected in a pediatric clinic. Diabetic ketoacidosis was confirmed after her referral to our hospital. Case 4: a 5-year-old girl suffered from acute abdominal pain for four hours. She was found to have tachypnea, lethargy, and ill-looking. Diabetic ketoacidosis was diagnosed after serial examinations. The abdominal pain in diabetic ketoacidosis may lead the pediatrician into diagnostic error. Therefore, when a child presented with non-specific abdominal pain, a routine urine sugar should be checked in order not to miss the possibility of diabetic ketoacidosis.
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PMID:[Abdominal pain in diabetic ketoacidosis: report of four cases]. 212 98

In the period between 1984 and 1988 laparoscopy was conducted 846 times in children with suspected acute appendicitis. In 301 children the diagnosis was confirmed in atypical forms of appendicitis. In 418 children laparoscopy revealed diseases which are recognized with great difficulties (mesadenitis, primary peritonitis, genital diseases, etc.), in which the final diagnosis is usually established during laparotomy. In 39 children laparoscopic diagnosis was conducted during intercurrent diseases in which the abdominal pain syndrome simulated the clinical picture of acute appendicitis. As the result of laparoscopic examination the number of operations for simple forms reduced from 38.3 to 6.2% and the timely diagnosis of acute appendicitis improved.
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PMID:[Laparoscopy in the diagnosis of acute appendicitis in children]. 214 68

The appendectomy-rate in the Federal Republic of Germany is decreasing. German surgeons have begun to refuse appendectomy if there are no signs of acute inflammation. Preoperative assessment of patients with right lower quadrant pain has acquired new significance. The authors report on 2 years of experience with routine use of high-resolution ultrasonography in 669 cases of suspected acute appendicitis. Only 101 patients (= 15.1%) turned out to be suffering from acute appendicitis. Ultrasonography evaluation was found to have a sensitivity of 84.2%, a specificity of 96.8% and an overall accuracy of 94.9%. Ultrasonography was also useful in detecting mimicking diseases of acute appendicitis. Sonography should help to rule out severe disease in the frequent cases of functional abdominal pain.
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PMID:[Sonography in suspected appendicitis: a decisive factor in diagnosis and therapy? Results of a prospective study of 669 patients]. 216 Jun 81

A 41-year-old male, complaining of an abdominal pain and suspected of having acute appendicitis, underwent examination on hospitalization. Ultrasonography revealed a tumorous lesion of the appendix. Thus, a laparotomy was performed and mass lesions were found in the mid and distal parts of the appendix. A subsequent histological examination revealed an inflammatory pseudotumor consisting of remarkable eosinophilic cell and fibroblastic infiltrations, similar to that seen in a inflammatory fibroid polyp (Helwig). Although such lesions, polypoid in appearance, have been found to occur in the stomach and intestines, to find them in the appendix is extremely rare. In this instance, as the growth of this mass of lesions was more predominant in the wall rather than in intraluminal area, it was decided that pseudotumor was the appropriate term to describe this case.
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PMID:[An inflammatory pseudotumor of the appendix]. 219 95


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