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

An unusual case of colitis in a 37-year-old cocaine addict is described. The patient presented with right-sided abdominal pain and diarrhea exacerbated by his use of cocaine. Significant antibiotic ingestion was denied. At laparotomy, an edematous cecum and ascending colon were found, the cut surface of which revealed diffuse superficial ulcerations and yellowish fibrinous material. Microscopic examination demonstrated findings consistent with pseudomembranous colitis with an ischemic component. A mechanism involving catecholamine-induced mucosal ischemia is postulated to explain the findings seen in this patient.
Dis Colon Rectum 1985 Apr
PMID:Cocaine colitis. Is this a new syndrome? 397 30

A 50-year-old woman presented with a long history of nausea, abdominal pain, weight loss, and intermittent watery diarrhea. All investigations were negative except for the finding, on five separate colonoscopic biopsies, of a layer of band-like collagen beneath the surface epithelium, diagnostic of collagenous colitis.
Dis Colon Rectum 1984 Feb
PMID:Collagenous colitis. Report of a case. 669 27

Five cases of mobile cecum syndrome are presented. These patients all presented with chronic right lower quadrant abdominal pain with associated abdominal distention and symptomatic relief after passing flatus or having a bowel movement. Three patients had preoperative barium enemas demonstrating abnormal mobility of the cecum. On exploration, all patients were found to have the cecum and ascending colon unattached to the lateral peritoneum for 15 to 18 cm. All patients were treated by cecopexy, using a lateral peritoneal flap for fixation, and all have had relief of their pain. This technique is described and illustrated. Cecopexy is an effective method of fixing the cecum and prevents subsequent cecal volvulus. The diagnosis of mobile cecum syndrome should be considered in patients with chronic right lower quadrant pain.
Dis Colon Rectum 1984 Jun
PMID:Mobile cecum syndrome. 673 64

Alimentary tract duplications are rare anomalies that present with a wide spectrum of clinical manifestations. Mass lesions or obstructive symptoms predominate in infancy, while pain and hemorrhagic complications often herald their recognition in childhood. Spontaneous perforation, a rarely encountered complication, accounted for the acute exacerbation of previously chronic abdominal pain in a three-year-old girl. This case emphasizes the potential for these benign lesions to present with progressive abdominal symptoms and ultimately pressure-induced ischemic perforation.
Dis Colon Rectum 1983 Apr
PMID:Spontaneous perforation of a colonic duplication. 683 1

Leiomyosarcoma of the colon, excluding that of the rectum, is extremely rare. We report a case of leiomyosarcoma of the ascending colon with a brief review of literature. The clinical manifestations in our case were typical: abdominal pain, diarrhea, anorexia, and a palpable tumor that was firm, smooth, and mobile inspite of its bulk. Toxic features, cachexia and weight loss were less prominent. Morphologically the tumor was of dumbbell type with intracolic and extracolic components. The microscopic picture, consisting of spindle-shaped smooth-muscle cells with pleomorphism and one to three mitotic figures per high-power field, was characteristic. In the absence of local spread, a hemicolectomy was considered curative, but our patient developed extensive metastasis in 25 months. The correlation between mitotic activity of the tumor and prognosis in our case was consistent with that reported in literature.
Dis Colon Rectum 1980 Apr
PMID:Leiomyosarcoma of the colon: a case report and review of literature. 699 Dec 30

The authors' experience with right-sided diverticulitis is reviewed. The symptoms among 18 patients were continuous right lower quadrant abdominal pain and periumbilical pain radiating to the right lower quadrant. Only three patients had nausea and vomiting. Twelve patients (67 per cent) had an abnormally high white blood cell count; three had granulocytosis. Barium enema examination was not a helpful diagnostic aid; and in only two patients was the preoperative diagnosis correct. The operative procedures undertaken were right colectomy with ileotransverse colostomy (15 patients), partial right colectomy with ileoascending colostomy (two patients), and diverticulectomy and appendectomy (one patient). There were no deaths; the average hospital stay was 14.2 days (range 5 to 30 days). The authors conclude that there is no characteristic clinical pattern pointing to this diagnosis; diagnostic maneuvers are usually unrewarding; right hemicolectomy is a safe and expeditious procedure; and open cecotomy is not favored, as recommended in the medical literature, to establish the diagnosis.
Dis Colon Rectum 1982 Apr
PMID:Diverticulitis of the right colon. 706 66

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.
Dis Colon Rectum 1982 Sep
PMID:The diagnosis of colonic obstruction. 711 69

Evanescent colitis was first reported in 1971. This clinical entity is manifested by abrupt onset of colicky abdominal pain usually out of proportion to the physical findings, loose stools progressing to hematochezia, and segmental colonic involvement with spontaneous resolution in a matter of days. The diagnosis can be suggested by abdominal flat plate; confirmation depends upon barium-enema examination early in the course of the illness. The clinical presentation is identical to that of colonic ischemia with one remarkable exception: while colonic ischemia has come to be regarded as a disease of the elderly, usually with underlying vascular disease, evanescent colitis occurs in young people who are otherwise free of disease. In this report the authors present nine cases whose course is classic for colonic ischemia except that they are all less than 50 years of age and free of underlying vascular disease. Two of the patients were on oral contraceptive medication. A review of the literature revealed 15 additional cases. Five of these cases were associated with oral contraceptives. Conditions to be excluded in the differential diagnosis of this disease are the specific infectious colitides, idiopathic ulcerative colitis, granulomatous colitis and antibiotic-related pseudomembranous colitis.
Dis Colon Rectum 1981 Oct
PMID:Evanescent colitis. 729 67

Recently a patient with ulcerative colitis developed abdominal pain and a left upper quadrant mass. A 67Ga-citrate scintiscan showed increased activity over the mass. A barium enema demonstrated retrograde obstruction at the splenic flexure and intraluminal multilobulated tissue masses. The total abdominal colectomy specimen showed localized giant pseudopolyposis at the splenic flexure. This condition is a rare local complication of both ulcerative and granulomatous colitis. It resembles a villous adenoma on barium enema and, although inflammatory, may simulate a colonic carcinoma. When symptomatic, local resection may be sufficient treatment.
Dis Colon Rectum
PMID:Localized giant pseudopolyposis of the colon in ulcerative colitis. 738 23

Acute mesenteric ischemia represents one to two percent of all gastrointestinal illnesses. There are three possible causes of acute arterial mesenteric ischemia: embolism, thrombosis, and nonocclusive mesenteric insufficiency. The key to early diagnosis is a high index of suspicion. The classic clinical picture of obvious cardiac disease, sudden onset of severe abdominal pain and gastrointestinal emptying, is not always present. Serum markers and plain films are often nondiagnostic but may suggest acute arterial mesenteric ischemia. Angiography establishes the diagnosis and allows for planning of aortomesenteric bypass, if indicated. Papaverine is immediately instilled to decrease splanchnic vasoconstriction. Embolic and thrombotic disease is treated by laparotomy with re-establishment of visceral perfusion. Only after blood flow is restored is nonviable bowel resected. Clinical methods of assessing intestinal viability include Doppler scanning, intravascular dyes, and tissue oximetry. The decision to perform a second-look laparotomy is made prior to closure of the abdomen. Pharmacologic treatment is the mainstay of nonocclusive ischemia. Surgery is reserved for clinical deterioration. Survival is dependent on the cause and extent of occlusion as well as the rapidity of diagnosis and therapy. Bowel necrosis results in mortality rates between 80 percent and 95 percent.
Dis Colon Rectum 1994 Nov
PMID:Mesenteric ischemia. Acute arterial syndromes. 760 44


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