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

The results of the radiological examination of 330 children following oral administration of barium are reported. It is pointed out that if one just takes into account the undoubted organic diseases, only a few children would benefit from the examination; in our case only 9 of them (a gastric and a duodenal ulcer, a pancreas pseudocyst, 5 hiatal hernias, and a celiac disease), i.e. 3%. This is not very satisfactory from a practical point of view. This situation improves radically when one looks for diseases usually rated as questionable: small hiatal hernia (cardiotuberositary malposition), functional disturbances of the small intestine, reactive hyperplasia of the lymphoid tissue, and chronic appendicitis. Thus we were able to offer 177 children, i.e. 53% of them, an efficacious therapy. The importance of chronic appendicitis and of functional disturbances of the small intestine as a cause of abdominal pain in children is pointed out, and their radiological symptoms are discussed. Finally the not uncommon, but not very well known disease of incomplete sigmoid volvulus is described.
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PMID:[Radiologic findings in abdominal pain in children (author's transl)]. 42 1

Recurrent appendicitis and chronic appendicitis are the subjects of much controversy, but long-standing inflammation of the appendix and surrounding tissues has been reported in rare instances. We have described two patients, both with recurrent episodes of abdominal pain, who subsequently were shown to have chronic appendiceal disease. Appendiceal disease should be considered in the differential diagnosis in patients with recurrent abdominal pain.
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PMID:Recurrent abdominal pain due to chronic appendiceal disease. 206 39

Obscure, chronically recurring pains in the lower abdomen and back are common symptoms in the office of the gynecologist or practitioner. Often the cause has never been found. Many are functional or psychosomatic disturbances. There is no objective measurement of the quality or amount of pain. Common diagnoses have been chronic adnexitis, chronic appendicitis, retroflexion of the uterus, or adhesions. Too often surgical operations have been of little benefit. When consultations with other specialists have not helped, laparoscopy is indicated. Endometriosis is a common finding. Cauteriziation of this lesion at laparoscopy is better than hormone therapy. Adhesions may be severed with relief of symptoms. Varicose enlargement of ovarian veins is sometimes seen. Laparotomy may be indicated for conditions not readily treated by laparoscopy. However, indications for surgery should be carefully considered to avoid iatrogenic damage in an already apprehensive patient. Tranquilizers and small doses of cortisone may be adequate. In about 80% of patients complaining of chronic lower abdominal pain, organic disorders may be found by laparoscopy. The procedure should be recommended more frequently.
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PMID:Chronic pelvic disease of unknown origin. 427 10

Erythema annulare centrifugum (EAC), a chronic figurate eruption, occurred in a 28-year-old male physician several months following the onset of recurrent abdominal pain. Two months after the manifestation of EAC, another episode of abdominal pain culminated in appendectomy for perforated appendicitis. During his convalescence, the skin lesions faded and did not reappear. We propose that recurrent appendiceal inflammation caused both the episodic pain and the skin eruptions. Additionally EAC may be a sign of chronic infection, internal malignancy, or food allergy. Although truly chronic appendicitis is a disputed entity, recurrent, spontaneously resolving episodes of appendicitis occasionally do precede surgical appendicitis. The presence of EAC in a patient having recurrent abdominal pain should discourage a precipitant diagnosis of functional illness and prompt further investigation.
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PMID:Recurrent acute appendicitis with erythema annulare centrifugum. 648 95

Uterine perforation is known to be associated with IUD use. Usually the perforation occurs upon insertion, but the IUD can become embedded in the uterus and later be forced through the wall by uterine contractions. On occasion, IUDs have been noted in abdominal viscera, most often the sigmoid colon. Recently, a 20-year-old black woman was encountered whose Copper-7 IUD had perforated her appendix and had caused chronic appendicitis during pregnancy. The woman had had 3 live-born children and 1 spontaneous abortion. The Copper-7 had been inserted 6 months previously without apparent difficulty. At 21 weeks' gestation, the patient developed right lower abdominal pain radiating to the right buttock. She had no other gastrointestinal complaints, was afebrile, and exhibited no abnormal physical findings to explain her symptoms. Urine cultures were negative. 12 weeks later, the patient developed nausea, vomiting, anorexia, and constipation. She was again afebrile. After spontaneous labor at 40 weeks, the patient was delivered of a normal male infant. Following spontaneous expulsion of the placenta, the uterus was manually explored, and no IUD was found. The patient desired postpartum tubal ligation. An x-ray film of the abdomen revealed a Copper-7 IUD in the right lower quadrant at the level of the iliac crest. During the operation, it was noted that the IUD had apparently perforated the uterus 1 centimeter below the right uterotubal junction. The strings were in the myometrium, but the body of the IUD had passed transversely through the lumen of the appendix and remained embedded in it. The IUD may have induced inflammation in an otherwise normal appendix, and this seems most likely particularly because copper-containing IUDs are prone to cause irritation and adhesion formation.
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PMID:Appendiceal perforation by Copper-7 intrauterine contraceptive device. 729 85

Episodic abdominal pain, a common clinical problem, can be a diagnostic and therapeutic conundrum when the surgeon encounters it acutely in the emergency department. Appendicitis is often excluded from the differential diagnosis because the natural history of appendicitis is usually appreciated as acute, progressing to some degree of peritonitis quite rapidly and inevitably. However, recurrent and chronic forms of appendicitis occur also and can mislead the clinician. Herein, we describe two patients with recurrent appendicitis that were misinterpreted as other abdominal conditions, and we review the literature implicating recurrent and chronic appendicitis as disease processes, distinct from acute appendicitis, that occur with an incidence of approximately 10 per cent and 1 per cent, respectively.
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PMID:Recurrent and chronic appendicitis: the other inflammatory conditions of the appendix. 811 86

Those having chronic and recurrent appendicitis represent a small portion of patients with disorders of the appendix. We present a series of nine patients who underwent appendectomy for chronic or recurrent appendicitis at The Johns Hopkins Hospital, Baltimore, Maryland, between July 1984 and October 1992. There were seven women and two men (median age of 30 years, range of 15 to 63 years). All patients presented with pain in the right lower quadrant or lower abdomen of three or more weeks duration (mean of 16.0 +/- 8.4 months, range of three weeks to seven years), had no alternative diagnosis to account for the symptoms, had pathologic evidence of chronic inflammation or fibrosis of the appendix and had complete relief of the symptoms after appendectomy. Although the patients presented herein had clinical and pathologic evidence for recurrent or chronic appendicitis, careful review of the course of each patient before surgical referral revealed at least one episode of acute pain in the abdomen consistent with acute appendicitis managed by nonoperative means. This suggests that, while recurrent acute appendicitis and chronic appendicitis do occur, they can be avoided by the accurate diagnosis and operative management of acute appendicitis. We conclude that acute appendicitis can resolve spontaneously and recur repeatedly in the same individual; in the evaluation of a patient with abdominal pain, a history of prior similar episodes of pain should never dissuade one from considering the diagnosis of acute appendicitis, and recurrent acute appendicitis and chronic appendicitis should be considered in the differential diagnosis of recurrent pain in the lower abdomen.
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PMID:Chronic and recurrent appendicitis are uncommon entities often misdiagnosed. 814 38

During a 13-month period (March 1, 1995 March 31, 1996) the authors performed in 70 children a laparoscopically assisted appendectomy. 68 children were operated on account of chronic appendicitis, two on account of acute appendicitis. During the postoperative period early, not very serious, postoperative complications were recorded in 7 children. One girl had on the second day after operation fever and severe abdominal pain, four children developed on the 5th-7th day after surgery abdominal pain, associated in three instances with fever and in two instances with the pathological finding of pericoecal fluid. The complaints receded within 1-2 days in all five patients after conservative treatment. In another two children the wound healed per secundam intentionem. No late complications were recorded.
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PMID:[Laparoscopy-assisted appendectomy in children]. 901 49

We report herein the rare case of a 15-year-old girl with chronic appendicitis in whom the appendix was clearly depicted by a barium enema (BE) examination. The patient presented with a 4-month history of diffuse abdominal pain and tenderness in the lower abdomen. Neither computed tomography nor ultrasonography showed any abnormal findings in the lower abdomen or pelvic cavity. Furthermore, BE examination depicted an appendix filled with the contrast medium. However, at elective surgery, she was found to have chronic appendicitis which was later confirmed histologically. Following this case report, a discussion on the value and limitations of BE examination for the diagnosis of acute and chronic appendicitis is presented.
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PMID:The appearance of a normal appendix on barium enema examination does not rule out a diagnosis of chronic appendicitis: report of a case and review of the literature. 930 50

A prospective, observational study was performed to define the laparoscopic appearance of chronic or recurrent appendicitis, and to evaluate a new, simplified technique for laparoscopic appendectomy. Chronic appendicitis was assumed in 42 women with long-term or recurrent lower abdominal pain, and appendectomy was performed when two or all three of the following pathologic changes, which were highly predictive of the diagnosis, were present: vascular injection of appendiceal peritoneum, periappendiceal adhesions, and induration of the appendix. After thorough periappendiceal adhesiolysis, a catgut no. 2 endoloop was placed around the base of the appendix and mesoappendix. The appendix was skeletonized, crushed distal to the ligature, regrasped further distally while simultaneously closing the appendiceal lumen, and cut in the crushed area. It was removed retrograde through the left suprapubic 10-mm port. Iodine was applied to the stump. No major intraoperative or postoperative complications occurred. During mean observation of 12.6 months, 74% of women were free of abdominal pain, 12% had partial relief in a mean of 15.4 months' observation, and 12% experienced no change in abdominal pain. This technique is safe, simple, and effective when chronic or recurrent appendicitis is assumed during diagnostic laparoscopy for chronic lower abdominal pain.
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PMID:Gynecologically indicated single-endoloop laparoscopic appendectomy. 966 50


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