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

Serum C-reactive protein was measured in 56 patients hospitalized with a suspected diagnosis of acute appendicitis. Based on these determinations, four groups of patients were defined: Group A = 26 patients with acute appendicitis who had a C-reactive protein level higher than 2.5 mg/dl. Group B = 4 patients with a C-reactive protein level lower than 2.5 mg/dl who, after surgery based on a presumed diagnosis of acute appendicitis, were found to have a normal appendix. Group C = 22 patients with nonspecific abdominal pain, 18 (72 percent) of whom had an elevated C-reactive protein level, although in only 4 (7.1 percent) were these levels higher than 2.5 percent mg/dl. Group D = 4 patients who had diseases other than acute appendicitis. It is concluded that an increase in C-reactive protein levels to more than 2.5 mg/dl is not a definite indicator of acute appendicitis. However, if the C-reactive protein level in blood drawn 12 hours after the onset of symptoms is less than 2.5 mg/dl, acute appendicitis can be excluded.
Dis Colon Rectum 1994 Jan
PMID:Diagnostic value of C-reactive protein in acute appendicitis. 828 47

Intestinal nonrotation has been recognized as a cause of obstruction in neonates and children and may be complicated by volvulus and intestinal necrosis. It is very rarely seen in the adult and may present acutely as a bowel obstruction and intestinal ischemia associated with midgut or ileocecal volvulus, or chronically as vague intermittent abdominal pain. The purpose of this communication is to reveal the pathogenesis and the surgical significance of intestinal nonrotation in adults and to review the English and German language literature since 1923 to establish the optimal therapeutic management. Between 1983 and 1992, we have managed and observed prospectively 10 adults with intestinal nonrotation. In four patients the nonrotation has been detected at emergency laparotomy owing to midgut or ileocecal volvulus. Four patients suffered from chronic symptoms of intermittent volvulus or small bowel obstruction and in two patients the nonrotation has been noted as an incidental finding at laparotomy for another condition. A survey of the literature from 1923 to 1992 revealed 40 adults with symptomatic intestinal nonrotation to which we contribute nine patients. We establish that in the acute symptomatic pattern, only emergency laparotomy can provide the correct diagnosis and decrease the risk of bowel disturbance. In the chronic situation, barium studies of the upper and lower gastrointestinal tract reveal varying degrees of midgut malrotation and confirm the nonrotation in each case. Also, in these forms the explorative laparotomy with a consequent staging of the abdominal situs is to be recommended. All reported cases at our institutions are without complaints after surgery. Adult patients with intestinal nonrotation and acute or chronic obstructive symptoms or those detected incidentally at laparotomy for other conditions should undergo a Ladd procedure because of the risk of midgut volvulus. In this operation, the nonrotation is left in place and the ascending colon is sutured at the colon descendens and sigmoideum. After this procedure the mesenteric pedicle is fixed and the risk of midgut torsion remains minimal.
Dis Colon Rectum 1994 Feb
PMID:Acute and chronic presentation of intestinal nonrotation in adults. 830 46

Villous adenomas are common neoplasms of the colon, often causing anemia or hemoccult positive stools. Less typically, these lesions may result in abdominal pain, melena, obstruction, or change in bowel habits. Intussusception may occur, but this complication is unusual in adults. Spontaneous bowel perforation attributable to colonic polyps has not been previously reported. We present here the first reported case of an adenomatous polyp with bowel perforation and bladder involvement.
Dis Colon Rectum 1997 Feb
PMID:Perforated villous adenoma of the cecum: report of a case. 907 65

We report a unique case of Candida albicans sacral osteomyelitis in a 48 year-old female with previously undiagnosed Crohn's disease. The patient was ill for one year with fatigue, weakness, and a 60-lb weight loss. At the time of presentation, she developed chills, fever, right lower quadrant abdominal pain, and right knee pain. Physical examination was significant for a palpable right lower quadrant abdominal mass. A computed tomographic scan of the abdomen and pelvis identified a large right-sided retroperitoneal mass, severe right hydronephrosis, and air within the right sacrum. Findings at laparotomy included small-bowel changes consistent with Crohn's disease, a multiloculated retroperitoneal abscess, and evidence of sacral osteomyelitis. A right hemicolectomy with sacral debridement and placement of presacral drains was performed. Bone cultures from the sacrum demonstrated a predominance of C. albicans, in addition to coliforms and enterococcus. The patient was placed on amphotericin B and intravenous antibiotics. Because serial computed tomographic scans of her pelvis demonstrated progression of her pelvic osteomyelitis to include the sacrum, right ilium, right acetabulum, and right femoral head, a repeat debridement with resection of the right femoral head was performed. After 12 months of follow-up, she was doing well without medications and had no constitutional symptoms or radiographic evidence of disease progression. This report illustrates a unique case of Crohn's disease presenting as sacral osteomyelitis secondary to small-bowel fistulization. Aggressive multidisciplinary surgical and medical management were the key to the successful management of this difficult case.
Dis Colon Rectum 1998 Dec
PMID:Fungal sacral osteomyelitis as the initial presentation of Crohn's disease of the small bowel: report of a case. 986 Mar 42

Intestinal pseudomembrane formation, sometimes a manifestation of antibiotic-associated diarrheal illnesses, is typically limited to the colon but rarely may affect the small bowel. A 56-year-old female taking antibiotics, who had undergone proctocolectomy for idiopathic inflammatory bowel disease, presented with septic shock and hypotension. A partial small-bowel resection revealed extensive mucosal pseudomembranes, which were cultured positive for Clostridium difficile. Intestinal drainage contents from an ileostomy were enzyme immunoassay positive for C. difficile toxin A. Gross and histopathologic features of the small-bowel resection specimen were similar to those characteristic of pseudomembranous colitis. The patient was treated successfully with metronidazole. These findings suggest a reservoir for C. difficile also exists in the small intestine and that conditions for enhanced mucosal susceptibility to C. difficile overgrowth may occur in the small-bowel environment of antibiotic-treated patients after colectomy. Pseudomembranous enteritis should be a consideration in those patients who present with purulent ostomy drainage, abdominal pain, fever, leukocytosis, or symptoms of septic shock.
Dis Colon Rectum 2000 Apr
PMID:Pseudomembranous enteritis after proctocolectomy: report of a case. 1078 57

A 54-year-old Japanese female with polyarteritis nodosa was admitted to the hospital. She developed lower abdominal pain accompanied by melena. A penetrating ulcer and extensive hemorrhaging were endoscopically observed in the sigmoid colon, and a sigmoidectomy was performed. The pathologic findings were a granuloma formation with lymphocytic infiltration and luminal occlusion of branches of the mesenteric arteries. Although the gastrointestinal tract is frequently involved in polyarteritis nodosa, the colon is rarely affected. To our knowledge, this is the first report of polyarteritis nodosa causing a penetrating ulcer of the colon.
Dis Colon Rectum 2001 Jul
PMID:Penetrating colon ulcer of polyarteritis nodosa: report of a case. 1149 85

A 53-year-old female presented with abdominal pain, and computed tomography scan revealed a small, calcified lesion in the wall of the transverse colon. The symptoms later disappeared spontaneously, and she remained in good health. However, four years later, she developed lancinating abdominal pain and was admitted to our hospital. A large tumor with calcification was found in the left upper abdominal cavity. Curative resection of the tumor was performed, and the histology was compatible with extraskeletal osteosarcoma. We speculated that the tumor originated from the colonic wall, because a small calcification was observed in the wall of the transverse colon four years before surgery. To the best of our knowledge, this is the first report of primary colonic osteosarcoma.
Dis Colon Rectum 2001 Sep
PMID:Primary osteosarcoma arising in the colon: report of a case. 1158 18

Ischemic colitis is typically limited to elderly patients who have concomitant disorders such as cardiovascular disease and chronic renal failure, but rarely affects a young person. The patient was an 18-year-old Japanese female who started dieting to obtain a slim figure three months before admission and presented with a two-month history of constipation and a sudden onset of lower abdominal pain and bloody diarrhea. She underwent colonoscopy, which revealed edema, hemorrhages, and several longitudinal shallow ulcers in the descending colon. Stool and blood culture results were negative for pathogens. She improved rapidly within five days without any specific therapies except intravenous hydration and anticholinergic agents, under the diagnosis of ischemic colitis. In this case constipation and dehydration associated with dieting seemed to be responsible for the development of ischemic colitis. We recommend that ischemic colitis should be included in the differential diagnosis of colitis with bleeding, even in patients younger than age 20 who do not have any predisposing factors.
Dis Colon Rectum 2002 Mar
PMID:Ischemic colitis caused by strict dieting in an 18-year-old female: report of a case. 1206 8

A 14-year-old female with Turner syndrome (karyotype 45,X) had a history of abdominal pain with distention, constipation, and fever. She was first operated on for the suspicion of appendicitis, failed to improve, and was later hospitalized for further investigation and treatment. Studies demonstrated an obstructing tumor of the transverse colon, and an emergency laparotomy was performed. The final diagnosis was a signet-ring cell carcinoma of the colon with diffuse peritoneal dissemination and metastasis to paracolic lymph nodes. On the basis of this case, we report the association of Turner syndrome with malignancies and also some aspects of colon cancer in childhood.
Dis Colon Rectum 2003 Nov
PMID:Colon cancer in a 14-year-old female with turner syndrome: report of a case. 1460 80

We report the case of a 44-year-old white man who presented with progressively worsening crampy abdominal pain and distention. Deterioration of his clinical picture along with leukocytosis and radiographic evidence of severe colonic dilation rendered exploratory laparotomy necessary. Greatly distended and inflamed transverse and descending colon were evident and an extended left colectomy was performed. Characteristic changes of leukocytoclastic vasculitis in the serosal and muscular layers of the resected colon were demonstrated at histopathologic examination. Systemic leukocytoclastic vasculitis, usually coexisting with Henoch-Schonlein purpura, commonly affects the small bowel with clinical evidence of ischemia or bleeding. Colon involvement is infrequently reported in the context of systemic disease. Isolated colonic leukocytoclastic vasculitis without extraintestinal manifestations is rare. A previously unreported case of localized leukocytoclastic vasculitis of the left colon resulting in the impressive presentation of megacolon, without the presence of any precipitating factor or associated systemic disease is presented here, with an overview of the related literature.
Dis Colon Rectum 2005 Jan
PMID:Isolated colonic leukocytoclastic vasculitis causing segmental megacolon: report of a rare case. 1569 Jun 76


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