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

Yersinia enterocolitica was isolated from the feces of 29 patients over a three-year period following the introduction of a selective culture medium. Y. enterocolitica was the third most common enteric pathogen after Campylobacter jejuni and Salmonella in this series of 3795 specimens from a predominantly adult population. The isolation rate of Y. enterocolitica was 0.9% and this represented 15.8% of positive cultures. The usual symptoms of Yersinia infection were diarrhea (93%) and abdominal pain (72%), often associated with tenderness in the right iliac fossa and fever. Fourteen patients required admission to hospital and four came to surgery for possible appendicitis. Acute terminal ileitis and mesenteric lymphadenitis were noted in each case. Two patients who were HLA-B27 positive had a reactive arthritis as their dominant complaint. In conclusion, Y. enterocolitica has emerged as a common cause of diarrhea in adults. It is an important cause of symptoms resembling those of acute appendicitis and is occasionally complicated by reactive arthritis.
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PMID:Clinical aspects of infection with Yersinia enterocolitica in adults. 330 48

Whether barium retained in the appendix can be a cause of acute appendicitis is debatable. We describe a 40-year-old man who developed nonspecific right abdominal pain 7 weeks after a barium enema, which proved to be normal. On abdominal film a distended appendix containing barium was seen, and at laparotomy acute appendicitis was present. Thus far, 26 cases of "barium appendicitis" have been reported. On the basis of the relevant literature and the cases collected, it is appropriate to draw the following conclusions: 1) With present knowledge it is not possible to state whether retained barium plays any etiologic role in the development of subsequent uncomplicated acute appendicitis. 2) If a later appendicitis does supervene, it carries a high risk of being complicated; barium seems to be responsible for the complication. 3) The longer the interval between the barium study and the subsequent appearance of acute appendicitis, the higher will be the risk of complications.
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PMID:Barium appendicitis: fact or fancy? Report of a case and review of the literature. 330 23

A clinical study of 22 cases of ovarian hemorrhage suggests that intraabdominal hemorrhage of 100 ml and above should be surgically treated. The study also found polycystic tendency and increased peripheral blood white blood cell count. 13 cases which were pathologically treated were diagnosed to be corpus luteum hemorrhage. Out of 26 cases with ovarian hemorrhage seen at Almeida Hospital in Oita, Japan, between 1976 and 1987, 4 cases were eliminated from the study because of pregnancy. No significant difference was found in terms of number of pregnancies or number of child births. 19 of 22 cases belonged to the age group 20-34. Hemorrhage occurred in 9 cases during the premenstrual period, from the 22nd day to the 28th day. It occurred after induced abortion in 5 cases. All 22 women complained of lower abdominal pain. 15 were diagnosed to have puncture of Douglas pouch. In 16 out 22 cases hemorrhage occurred in the left ovary. This is due to the fact what many with right side abdominal pain had already been operated elsewhere because of suspected appendicitis. No fever over 38 degrees celsius was found, but 8 cases had a slight temperature. 5 of 22 cases showed a peripheral blood white blood cell count over 10,000. This combination of two factors proved to be not so reliable in distinguishing between acute appendicitis and ovarian hemorrhage. 9 out of 11 cases which were diagnosed to have intraabdominal hemorrhage of 100 ml and above were still hemorrhaging at the time of operation. Therefore, hemorrhage of 100 ml, not 200 ml and above as in the past, should be surgically treated.
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PMID:[Idiopathic ovarian hemorrhage]. 336 Nov 83

The treatment of acute leukemia in childhood has been increasingly successful. Infectious complications are the major cause of morbidity and mortality among these patients receiving aggressive chemotherapy. In particular, neutropenic enterocolitis or typhlitis has had a reported mortality of 50% to 100%. The authors reviewed a series of 77 previously untreated patients with acute myelogenous leukemia begun on treatment from March 1976 to June 1984 to better define the characteristics of typhlitis and its optimum management. Twenty-five patients had episodes of typhlitis, characterized by fever, abdominal pain, and tenderness, occurring during periods of neutropenia. Ten of these patients had watery diarrhea as a major additional symptom, and nine patients had a significant episode of gastrointestinal bleeding. In seven instances, blood culture results were positive, all for intestinal flora. The episodes of typhlitis occurred most frequently during the induction therapy (19 patients). Five patients experienced typhlitis during maintenance therapy, and one patient had acute appendicitis. Two patients had typhlitis during their reinduction therapy, and of note, one had had abdominal symptoms during her initial induction. All patients were treated initially with broad-spectrum antibiotics and bowel rest. Four criteria have been used for surgical intervention: (1) persistent gastrointestinal bleeding after resolution of neutropenia and thrombocytopenia and correction of clotting abnormalities; (2) evidence of free intraperitoneal perforation; (3) clinical deterioration requiring support with vasopressors, or large volumes of fluid, suggesting uncontrolled sepsis; and (4) development of symptoms of an intra-abdominal process, in the absence of neutropenia, which would normally require surgery. Using these criteria, five patients required surgical intervention for typhlitis or its sequelae and one for acute appendicitis. There was one perioperative death resulting from miliary tuberculosis. Among the 21 patients managed medically, there was 1 death resulting from typhlitis in a patient in whom surgery was deferred because of her multiple failures to enter remission.
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PMID:The medical and surgical management of typhlitis in children with acute nonlymphocytic (myelogenous) leukemia. 348 59

A 43-year-old man, with a chief complaint of abdominal pain and a palpable mass in the lower abdomen, was admitted to this hospital. He had 2-3 episodes of diarrhea monthly for several years. Laparotomy revealed the mass resembling sarcoma, invaded the ileum and bladder and also it had disseminated lesions in the other intraabdominal organs. Resected tissues showed actinomycotic abscess. AB-PC was administered post-operatively, with a satisfactory prognosis. On the 71 patients with abdominal actinomycosis who underwent laparotomy during the past 32 years in Japan, 42 were males and 28 females. Many of them were in their forties or fifties. Some literatures mention the ileocecal region as the usual site of following perforated appendicitis. As far as this review is concerned, however, the transverse colon was as frequently affected as the ileocecal region and it was only in 13 patients that acute appendicitis preceded the infection. Abdominal actinomycosis is not an uncommon disease and should be taken into consideration in the differential diagnosis of the abdominal mass.
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PMID:[A case of abdominal actinomycosis]. 360 May 98

Interstitial pregnancy is an infrequent type of ectopic pregnancy. Two cases of acute abdomen due to ruptured interstitial pregnancy following salpingectomy, a rare event, are presented. Both patients were young women who had had a previous salpingo-oophorectomy due to ovarian cyst. The presenting symptoms were in the first case abdominal pain followed by hemorrhagic shock, and in the second a right iliac fossa syndrome simulating acute appendicitis. Surgical intervention consisted of wedge resection of the uterine segment involved. A review of the literature and practical considerations are presented.
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PMID:Acute abdomen in ruptured interstitial pregnancy following unilateral salpingectomy. 366 74

776 patients seen in our emergency ward with abdominal pain for less than one week duration were prospectively analysed. In 49% of these patients no cause was found and 19% had acute appendicitis. Among 180 appendectomized patients, 147 (82%) had acute appendicitis whereas 33 (18%) had no inflammation of the appendix. Clinical presentation with a pain duration of less than 36 hours, steady abdominal pain, guarding in the right iliac fossa and a white cell count above 12,000/mm3 (12 g/l) were the best criteria for prediction of acute appendicitis versus a normal appendix. Perforated appendicitis was found in 18% of the patients with acute appendicitis but in only one patient for whom appendectomy had been deferred on the grounds of atypical presentation. Thus, in most cases, the perforation was preexistent to admission. We therefore recommended a 24-48-hour observation period for patients with uncertain diagnosis. Rates of normal appendices and perforated appendices of about 20% seem to be difficult to improve upon.
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PMID:[A prospective study of 776 cases of acute non-traumatic abdominal pain. Acute appendicitis and its diagnosis]. 367 66

The emergency physician is frequently frustrated by the symptom of recurrent abdominal pain. This complaint is particularly troubling when the patient localizes the pain to the right lower quadrant. On an isolated visit, acute appendicitis is the condition which demands primary consideration, because of both its frequency and the consequences of failure to make a prompt diagnosis. When right lower quadrant abdominal pain is recognized as being recurrent, the emergency department physician must consider a broader range of diagnostic possibilities. This illustrative case presents one unusual element of the differential diagnosis of this symptom.
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PMID:Eosinophilic granuloma of the appendix. 384 39

Stool specimens of 478 children with enteritic symptoms were screened for enteropathogenic bacteria over a 5-month period. 28 cases of infection due to Campylobacter jejuni were found. The incidence of Campylobacter enteritis exceeded that of salmonella and shigella infections recorded over the same period (17 and 11 cases, respectively). Infected children-aged between 2 months and 15 1/2 years-presented with symptoms of mild gastroenteritis. 18 patients had bloody diarrhoea, whilst 4 children aged between 4 and 9 years with abdominal pain showed a clinical picture mimicking acute appendicitis. Two severely dehydrated infants required parenteral fluids, but in the remaining cases dietetic treatment alone proved satisfactory.
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PMID:[Epidemiology and clinical aspects of Campylobacter enteritis in childhood]. 389 Mar 73

Since the turn of the century, the elderly population, particularly those over the age of 80, has been increasing steadily. Consequently, the surgeon will be confronted frequently with the diagnostic challenge of acute appendicitis in this population. Over the past ten years, 13 patients over the age of 80 were treated for acute appendicitis at the St. Lukes-Roosevelt Hospital Center. The mean duration of symptoms was 2.4 days; all patients complained of abdominal pain, with 72 percent of patients having right lower quadrant involvement. Ninety-two percent had perforated prior to surgery, and 23 percent did not survive the disease. This high mortality rate is attributed to both a delay in presentation to the physician and a further delay in proper treatment due to misdiagnosis. This is a disease with which every physician must be familiar and be continually vigilant, as correct diagnosis and prompt treatment are the keys to averting high morbidity and mortality rates.
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PMID:The diagnosis and treatment of acute appendicitis in the aged. 394 30


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