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

Cases of endometriosis of the colon were examined in a retrospective fashion to illustrate the problems in diagnosis and management of this disease entity. Nine patients were identified from 1956 to 1988; their average age was 41 years. Common presenting symptoms were abdominal pain, diarrhea, constipation, tenesmus, small caliber stools, abdominal distention, and blood per rectum. Bowel symptoms were cyclic in four of the nine patients, and seven had a history of gynecologic complaints. Barium enema was performed in six patients and endoscopy in five patients. All cases involved the sigmoid or rectosigmoid colon. In no case was the diagnosis established endoscopically. Surgical procedures included resection with primary anastomosis (6 patients), and resection with sigmoid endcolostomy and Hartmann's pouch (3 patients). In only one case was full-thickness colonic wall involvement noted. One patient had an adenocarcinoma of the colon adjacent to the area of endometriosis. Our data indicate that the diagnosis of endometriosis of the colon should be considered in women with colonic symptoms, especially with an associated history of dysmenorrhea or cyclic changes in bowel habits. Surgical resection offers the best chance for relief of symptoms.
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PMID:Endometriosis of the colon. Its diagnosis and management. 233 65

Although en bloc resection for contiguous invasion by adenocarcinoma of the colon is a well-recognized principle, it is difficult to assess the efficacy of this principle when upper abdominal viscera are involved. This study was undertaken to better define this subgroup. Seventeen patients were studied over a period of 20 years who underwent extended resections for colonic adenocarcinoma with upper abdominal organ invasion. The age range was 30 to 81 years (average, 61 years). There was a male-to-female ratio of greater than 2:1. The duration of presenting symptoms was as short as 4 days and as long as 18 months (average, 4.3 months). The most common complaint was weight loss (13/17). The next most common complaints were abdominal pain (10/17), bowel complaints (5/17), and septic symptoms (4/17). A single organ was involved in 7 instances, but multiple organs were involved in most cases. The frequency of involvement was the stomach, spleen, and duodenum (5 each), abdominal wall and diaphragm (4 each), pancreas and liver (3 each). There were 2 perioperative deaths and 9 other major complications. The most common cause of morbidity and mortality was septic in nature in 8 of the 11 instances. All 3 patients with pancreatic resections had postoperative complications; none were fatal. Five patients survived over 10 years, three were 5-year survivors, and two are living and free of disease at less than 5 years. Excluding the two perioperative deaths, four of the five patients who died in less than 5 years had documented recurrences.
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PMID:En bloc resection for contiguous upper abdominal invasion by adenocarcinoma of the colon. 275 52

A retrospective study was carried out in nine children between the ages of 10 and 20 years with adenocarcinoma of the colon. No family history, significant medical history, or predisposing factors were identified, except for Turcot's syndrome in one child. Common presenting signs and symptoms were vague abdominal pain, nausea and vomiting, weight loss, change in bowel habits, and guaiac-positive stools. Five of the patients' diagnoses were delayed for an average of 11.6 months, the majority of whom had Dukes' D disease. Their median survival was 4 months compared with 24 months in the four patients diagnosed early. As with adults, the mainstay of therapy is operation. Our data indicate that an increased awareness and consideration of colon cancer in children will result in earlier diagnosis, a more favorable disease stage, and prolonged survival.
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PMID:Adenocarcinoma of the colon in adolescents. 320 57

We report on a patient with colon cancer and a very high serum alpha-fetoprotein level. This 75-yr-old man presented with right lower quadrant abdominal pain. An abdominal CT scan as well as ultrasonography showed a tumor in the cecum. Serum alpha-fetoprotein level was extremely high (3,070 ng/ml). At laparotomy, a large mass was found in the cecum, and a right hemicolectomy was performed. Histological examination, including immunohistochemical study, showed an adenocarcinoma of the colon producing alpha-fetoprotein.
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PMID:Colon cancer with a high serum alpha-fetoprotein level. 863 53

A 34-year-old woman presented at 19 weeks in her third pregnancy with abdominal pain and hyperemesis. This was her third admission during the pregnancy for similar complaints. A few days after admission an exacerbation in her pain was noted, in particular on eating or lying down, and a firm and mobile epigastric mass could be palpated separate from her uterus. The differential diagnosis was a hernia or a degenerating pedunculated fibroid. Sonography revealed a mass separate from the uterus with an appearance consistent with intussusception. Magnetic resonance imaging confirmed the diagnosis. A limited right hemicolectomy was performed. The final diagnosis was adenocarcinoma of the colon. It is difficult to diagnose intussusception during pregnancy. The presenting symptoms of nausea, vomiting, abdominal pain and constipation are common in pregnancy and the displacement of the bowel by the gravid uterus hampers examination. Intussusception is very rare in adults and generally it is associated with tumors. Preoperative diagnosis is difficult but possible with accurate imaging.
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PMID:Intussusception: a rare cause of abdominal pain in pregnancy. 1695 24

We describe the case of a 62-year-old patient with fever and abdominal pain of the right upper quadrant with a known history of adenocarcinoma of the colon and presence of hepatic metastases. One of the liver lesions underwent aspiration, and pus was sent for microbiological testing. Cultures of the pus were positive for Klebsiella pneumoniae and Candida albicans and polymerase chain reaction for Mycobacterium tuberculosis was concurrently positive; the patient received treatment for all three pathogens and improved clinically. One may consider searching not only for the usual pathogens of liver abscesses (gram-negative bacteria, anaerobic bacteria and gram-positive bacteria), but in special cases might consider pursuing a more detailed search for coexistence of fungi and mycobacteria in patients with cancer.
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PMID:Concurrent M. tuberculosis, Klebsiella pneumoniae, and Candida albicans infection in liver metastasis of bowel carcinoma. 1829 6

In the last decade, we have found an increased incidence of gastrointestinal (GI) malignancies among Cystic Fibrosis (CF) patients. We discuss the case of a 30-year-old woman of mixed descent, with CF, who was referred to the emergency department for persistent abdominal pain and constipation, complicated by blood-streaked stools. On physical examination, her abdomen was soft, nontender, and without organomegaly or palpable masses. Rectal examination was unrevealing. The patient's initial laboratory evaluation revealed a hemoglobin level of 11.7g/dl. A CT scan of the abdomen was unremarkable. A colonoscopy performed one day after admission showed an intraluminal mass in the proximal Sigmoid Colon, from which biopsies were taken. Pathology reports subsequently revealed invasive Adenocarcinoma of the Colon. The patient underwent tumor resection followed by initiation of chemotherapy. The pathophysiology underlying the increased risk of GI cancers in CF patients is unknown. Possible explanations include genetic mutations or persistent pathologic alterations in digestive tract structures. It is our hope that this case will bring to light the need to further delineate cancer risk among CF patients and to develop screening recommendations tailored to this population.
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PMID:Colon cancer in cystic fibrosis patients: is this a growing problem? 1837 36

Gastrocolic Fistula is, in the majority of cases the pathological communication between stomach and transverse colon, because cases involved with the small intestine, pancreas and skin have been also documented, even though are rare. It occurs mostly in adults, but they can be present to infants, as well, as a result of congenital abnormalities or iatrogenic procedures (i.e. migration of PEG tube that placed before). In the Western Countries, the most common cause is the adenocarcinoma of the colon, while in Japan, adenocarcinoma of the stomach is the most frequent cause. It seldom appears, as a complication of a benign peptic ulcer, in Crohn's disease and as a result of significant intake of steroids or NSAIDs. The typical symptoms of a gastrocolic fistula are abdominal pain, nausea-vomiting, diarrhea and weight loss. Radiology has been used for the detection of the fistulae all these years but the golden standard remained the barium enema. Barium meal and CT findings play a smaller role in the diagnosis. Although the management of gastrocolic fistulae has historically been surgical, medical treatment has recently been recommended as the first line when a malignancy can be excluded.
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PMID:Gastrocolic fistulae; From Haller till nowadays. 2236 8

Synchronous multiple colorectal cancers are defined as multiple malignant colorectal tumors that occur simultaneously. All tumors are distant from each other, and none are the result of metastasis from other tumors. Here, we present a case of a 79-year-old man who was admitted to our hospital because of a 3-month history of abdominal pain associated with anemia, loss of appetite, and body weight loss. The patient did not have a family history of cancer. Computed tomography revealed bowel wall thickness and mesentery inflammation at the hepatic flexure of the colon and cecum. Colonoscopy revealed a tumor located 10 cm from the anal verge. Colonoscopic examination of the large bowel was not possible because of bowel obstruction due to the rectal tumor. Synchronous triple adenocarcinoma of the colon and rectum was confirmed by pathologic examination. The tumor was surgically resected by two-segment resection of the colon, low anterior resection, and right hemicolectomy. We used intraoperative colonoscopy to confirm that there were no other lesions after the resection of the three tumors. To the best of our knowledge, this is the first case of synchronous triple carcinoma of the colon and rectum in Taiwan. We consider that comprehensive preoperative study, extensive intraoperative exploration, and radical resection can increase the survival rate of patients with synchronous multiple colorectal cancers.
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PMID:Synchronous triple carcinoma of the colon and rectum. 2349 55

Splenic angiosarcoma has been presented as an extremely rare malignant tumour. Amongst the rarest of all neoplasms, primary splenic angiosarcoma comprises 0.14-0.25 of all annually reported cases per one million persons Splenic angiosarcoma was first described in 1879 by T. Langerhans. The clinical symptoms and diagnostic values associated with splenic angiosarcoma are extremely variable. Nonetheless, majority of the patients (75%) complain of abdominal pain, and a quarter to one-third present with rupture of the involved organ. We hereby report our experience with two splenic angiosarcoma cases, which despite being similar in their diagnosis, nonetheless present with an entirely different clinical picture. Our first case, whereby the patient presented with a liver that was also affected by the angiosarcoma of the spleen. In the second case however, although the patient did show evidence of metastasis to the abdominal cavity as well as the liver, she also suffered from primary adenocarcinoma of the colon. To our knowledge, no previous article has made mention of primary splenic angiosarcoma existing independently of another primary neoplasm. Both may be found in common practice, and ought to be highlighted for their significance as such.
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PMID:Primary splenic angiosarcoma - the same diagnosis yielding two different clinical pictures. Case report. 2378 95


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