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

A 42-year-old woman presented with intractable crampy abdominal pain continuing for 1 year. The pain worsened after eating and improved when walking. She had undergone laparoscopic adjustable gastric banding 4 years previously, with re-banding 18 months later because of anterior band slippage. The patient underwent numerous examinations, all with normal findings. A scintigraphy finally showed some tracer enrichment in the terminal ileum, which led to the assumption that a Meckel's diverticulum was causing her discomfort. Subsequent diagnostic laparoscopy showed no Meckel's diverticulum but instead displaced tubing, which was wrapped around the mesenteric root. The mesenteric root showed scarred alterations from chronic strangulation. After replacing the tubing from the band the abdominal pain immediately vanished. In retrospect, the contrast study of the gastric band shows unnatural traction of the tubing towards the lower abdomen, allowing suspicion of the intraoperative findings.
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PMID:Intractable abdominal pain following laparoscopic adjustable gastric banding. 1625

We report a case of a 57-year-old woman admitted for abdominal pain and a not reducible mass in left inguino-abdominal region. With a diagnosis of strangulated inguinal hernia, the patient underwent urgent surgery. The surgical exploration showed a gangrenous intestinal loop with a Meckel's necrotic diverticulum. A small bowel resection (20 cm) was performed. The post-operative course was uneventful. This seems the first case reported in the literature of woman with a Meckel's diverticulum involved in a strangulated left inguinal hernia.
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PMID:[Gangrene of Meckel's diverticulum in strangulated left inguinal hernia]. 1637 Nov 91

Meckel's diverticulum is an evolution of omphalomesentric channel one of the most frequent embryologic abnormality of digestive tract. It is observed in two circumstances: during a routine exploration or after a complication: intestinal obstruction, peritonitis, recurrent abdominal pain. Only open or laparoscopic explorations allow a diagnosis. Resection of the diverticulum is recommended in children because the complications are frequent and serious. The preferred therapeutic method is the bowel resection with immediate anastomosis.
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PMID:[Laparoscopic surgery of Meckel's diverticulum]. 1653 Jan 54

Split notochord syndrome is a group of developmental abnormalities caused by abnormal splitting or deviation of the notochord, clinically resulting in the duplicated bowel associated with vertebral anomalies. In this syndrome, initial presentations due to duplicated bowel, vomiting, abdominal pain, and failure to thrive, usually occur before 1 year of age. We here report a 12-year-old boy with intermittent vomiting, previously diagnosed with cyclic vomiting syndrome. On abdominal x-ray examination, a defect in the closure of posterior vertebral arches was observed in the 5th lumbar vertebral body, indicating the complication of spina bifida occulta. This finding suggested the diagnosis of split notochord syndrome. A magnetic resonance imaging study revealed a cystic mass lesion in the pelvic cavity. (99m)Tc-pertechnetate scintigraphy, which is frequently used to detect ectopic gastric mucosa for the diagnosis of Meckel's diverticulum, showed a positive spot corresponding to the cystic mass lesion. Surgical resection of the cystic mass lesion demonstrated ileal duplication with ectopic gastric mucosa. Surgical findings suggest that symptoms of the patient were due to ulceration, inflammation, or bleeding caused by acid-peptic juice secreted from ectopic gastric mucosa. Duplication of the alimentary tract should be considered as a possible cause in patients with symptoms suggesting cyclic vomiting syndrome.
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PMID:Split notochord syndrome: ileal duplication causing intermittent episodes of vomiting. 1686 61

We report a child of elongated retrocecal appendicitis who presented with abdominal pain over the right upper quadrant and circular skin erythema over the right flank. Sonography showed an elongated tubular structure over the right abdomen. By the location, relationship to adjacent tissue and origin of tubular structure, the sonographic findings were differentiated from those of other similar diseases, such as colonic duplication or Meckel's diverticulum. This case illustrates retrocecal appendicitis should be considered as one of the differential diagnoses for earlier surgical intervention if a patient exhibits such atypical clinical manifestations accompanied with an elongated tubule structure of the right abdomen by sonography.
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PMID:Atypical manifestations of acute retrocecal appendicitis in a child. 1692 35

During a cholecystectomy for stones, an unusual lesion mimicking a neoplasm was found in a 40-year-old man. The lesion was resected using an endoscopic stapler, and the histologic diagnosis was Meckel's diverticulum with chronic inflammation and calcification of the diverticular wall. It is possible that the diverticulum had been responsible for abdominal pain in this patient, in whom it had an atypical appearance.
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PMID:Calcified Meckel's diverticulum: an unusual incidental finding during laparoscopy. 1736 93

The treatment of Meckel's diverticulum (MD) in children is resection. Some data exist for the use of laparoscopic resection. The Video-Assisted Transumbilical (VAT) single-trocar technique has been recently described for appendectomy. We also have used this technique for the resection of MD. The purpose of this study is to report our experience with laparoscopic-assisted resection of MD using both the three-trocar and the single-trocar techniques. The Institutional Review Board approved our retrospective chart review of all patients with the diagnosis of MD. Only the cases that were treated via laparoscopy were included. Technique of resection was at the discretion of the surgeon. Nine patients underwent laparoscopic resection of an MD from 2000 to 2005. Four patients underwent the three-trocar technique (LAP n = 4) and the remaining five underwent the video-assisted transumbilical single-trocar technique (VAT n = 5) procedure. Indications for surgery included gastrointestinal bleeding (VAT n = 3; LAP n = 2), malrotation (LAP n = 2), intussusception (VAT n = 1), and abdominal pain (VAT n = 1). All patients were male, and ages ranged from 7 months to 17 years for the VAT group and 8 months to 15 years for the LAP group. The average length of surgery for the LAP versus VAT was 128 minutes (94-170 minutes) and 81.4 minutes (42-96 minutes) respectively. Of the five patients undergoing LAP, two Ladd's procedures and three appendectomies were included during the same anesthesia. Only a single appendectomy procedure was performed during a VAT. The average time until full feeds with the LAP and VAT was 4.3 days (2-8 days) and 2.0 days (1-3 days) respectively. The overall length of stay with LAP versus VAT was 4.3 days (2-8 days) and 3.7 days (2-5 days). Only one case using the LAP method required conversion to an open laparotomy. Though no randomized trial for the removal of MD exists, our data suggest that the use of laparoscopy for removal of both symptomatic and asymptomatic MD is safe and effective. Additionally, the one trocar technique is feasible and may be beneficial in terms of fewer incisions and operative costs; however, more patients need to be studied.
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PMID:Video-assisted transumbilical Meckel's diverticulectomy in children. 1845 98

Intussusception of the bowel is defined as the telescoping of a proximal segment of the gastrointestinal tract within the lumen of the adjacent segment. This condition is frequent in children and presents with the classic triad of cramping abdominal pain, bloody diarrhea and a palpable tender mass. However, bowel intussusception in adults is considered a rare condition, accounting for 5% of all cases of intussusceptions and almost 1%-5% of bowel obstruction. Eight to twenty percent of cases are idiopathic, without a lead point lesion. Secondary intussusception is caused by organic lesions, such as inflammatory bowel disease, postoperative adhesions, Meckel's diverticulum, benign and malignant lesions, metastatic neoplasms or even iatrogenically, due to the presence of intestinal tubes, jejunostomy feeding tubes or after gastric surgery. Computed tomography is the most sensitive diagnostic modality and can distinguish between intussusceptions with and without a lead point. Surgery is the definitive treatment of adult intussusceptions. Formal bowel resection with oncological principles is followed for every case where a malignancy is suspected. Reduction of the intussuscepted bowel is considered safe for benign lesions in order to limit the extent of resection or to avoid the short bowel syndrome in certain circumstances.
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PMID:Intussusception of the bowel in adults: a review. 1915 43

This is a case of an otherwise asymptomatic Meckel's diverticulum, which became fibrously adherent to a previous umbilical laparoscopic port site, causing volvulus and small bowel obstruction in a pediatric patient. The diverticulum was diagnosed and resected laparoscopically, remaining bowel viability was maintained, and the child recovered without further sequelae. This complication, though rare, should be considered in the differential diagnosis when a child presents with abdominal pain after undergoing previous laparoscopic surgery. More important, this supports the consideration for the resection of asymptomatic Meckel's diverticulm when discovered incidentally, which is currently a controversial topic.
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PMID:Volvular small bowel obstruction secondary to adherence of a Meckel's diverticulum at a previous umbilical laparoscopic port site. 1921 18

A 19-year-old woman presented to the emergency department with intermittent and progressively worsening abdominal pain, nausea, and vomiting. A computed tomographic scan revealed findings consistent with distal small bowel obstruction of unknown etiology. In the operating room, a torsed and gangrenous Meckel's diverticulum with extension of ischemia to adjacent small bowel was discovered and immediately resected. Pathology confirmed the diagnosis of gangrenous Meckel's diverticulum. Torsion and gangrene of a Meckel's diverticulum is a rare complication and often presents with vague and poorly localized signs and symptoms. The preoperative diagnosis is often difficult and presumed to be appendicitis or small bowel obstruction of unclear etiology. Complications of Meckel's diverticulum should be considered in patients with lower abdominal pain and acute abdomen.
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PMID:Torsion and gangrene of a Meckel's diverticulum. 1927 65


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