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

A case of angiosarcoma of the large bowel is presented. The tumor occurred in a 16-year-old girl who presented with lower abdominal pain and rectal bleeding. A sigmoid colectomy was performed. Although macroscopic omental and pelvic peritoneal metastases were noted at operation, she did not receive adjuvant therapy and was alive and well more than three years after surgery. The literature on colonic angiosarcoma is also reviewed.
Dis Colon Rectum 1990 Apr
PMID:Angiosarcoma of the colon. Report of a case with long-term survival. 218 13

Defecography, pelvic floor electromyography, and segmental colonic transit times were performed in 74 patients with functional constipation. Signs of functional outlet obstruction occurred in 74 percent. Transit times were normal in 33 percent. Measurement of colonic transit time in patients with disordered evacuation studies is useless from a clinical point of view, because abnormal segmental transit time is the result of outlet obstruction in most cases and will return to normal after adequate treatment. Only when evacuation studies are normal, or have become normal after treatment and constipation persists, are segmental transit studies indicated because they may demonstrate primary slow transit constipation. Primary slow transit constipation probably is caused by impaired motility of the whole gastrointestinal tract. As small-bowel transit time increases, defecation frequency decreases, laxatives are taken again, and abdominal pain persists. Surgery should be performed with restraint.
Dis Colon Rectum 1990 Jan
PMID:Application of the colorectal laboratory in diagnosis and treatment of functional constipation. 229 75

The authors retrospectively reviewed the records of 50 patients whose initial diagnosis of Crohn's disease was made after the age of 50 years on the basis of strict histopathologic criteria. Progress of the 32 women and 18 men with a median age of 60 years (range, 50 to 78 years) was followed for a median of 95.5 months (range, 81.1 to 236.6 months). The most common presenting signs and symptoms were abdominal pain (82 percent), diarrhea (70 percent), weight loss (56 percent), bleeding from the gastrointestinal tract (26 percent), abdominal mass (16 percent), and fistula (14 percent). Initial operations performed were ileocolic resection (38 percent), proctocolectomy (16 percent), small bowel resection (10 percent), colostomy (2 percent), and a variety of segmental resections of the colon (34 percent). The overall recurrence rate of disease in patients in whom all obvious disease was resected, based on distribution of disease, was 80 percent (ileocolitis), 38 percent (ileitis), and 35 percent (colitis). Crohn's disease more often affects the distal gastrointestinal tract in older age groups. After resection, however, the clinical course is similar to that of the younger population. The high recurrence rate of Crohn's colitis is probably a result of the large number of initial segmental resections.
Dis Colon Rectum 1990 Jun
PMID:Clinical course of Crohn's disease in older patients. A retrospective study. 235 Sep 97

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.
Dis Colon Rectum 1989 Aug
PMID:En bloc resection for contiguous upper abdominal invasion by adenocarcinoma of the colon. 275 52

To assess prognostic factors in patients who develop colorectal cancer before the age of 40 years, a 30-year experience from 1956 through 1985 was reviewed. There were 50 patients ranging in age from 7 to 39 years. Five cases were associated with either ulcerative colitis (2) or familial polyposis (3). The most common presenting symptoms were abdominal pain (66 percent), hematochezia (60 percent), change in bowel habit (41 percent) and weight loss (30 percent). On pathologic staging (N = 44), only 14 of 44 (31 percent) had a Dukes' stage A or B lesion, 20 (45 percent) had Dukes' stage C, and the remaining 10 (23 percent) had distant metastases at the time of surgery. Five-year survival rate was 28 percent with a disease-free survival rate of 18 percent. Median survival was only 28 months. Negative prognostic factors were Dukes' stage C/D (P less than .001), symptom duration of longer than 3 months (P = .01), noncaucasian ancestry (P = .01), and poorly differentiated histology (P = .06). In contrast to older patients with colorectal cancer, only 1 of 30 (3 percent) patients with stage C D disease was disease-free at 5 years. In view of the poor survival rate associated with both delay in diagnosis and the presence of advanced disease, it was concluded that young patients presenting with the symptoms listed above need early, aggressive evaluation for possible colorectal cancer.
Dis Colon Rectum 1989 Oct
PMID:Colorectal cancer in patients younger than 40 years of age. 279 69

A 28-year-old woman with a previous history of restorative proctocolectomy for complicated ulcerative colitis had acute onset of severe abdominal pain that was diagnosed at another hospital as a perforated peptic ulcer. Careful history-taking revealed that she had blunt trauma to the abdomen one day before admission. Laparotomy detected a perforation hole at the afferent loop of the ileal pouch. Debridement and primary closure of the perforation, with temporary decompression of the pouch, resulted in a good outcome. With the increasing popularity of selecting restorative proctocolectomy for the treatment of polyposis coli and ulcerative colitis, more and more pouches will be constructed. Possible perforation of the ileal pouch should be considered when such patients present with a perforated hollow viscus. With appropriate management, the pouch can be saved. Review of the literature revealed no similar reports.
Dis Colon Rectum 1989 Jan
PMID:Traumatic perforation of ileal pouch. Report of a case. 291 Jun 62

Neutropenic typhlitis is a frequently fatal disease most commonly reported in leukemics. The authors have treated eight such patients over the last 18 months. All patients had abdominal pain and sepsis during chemotherapy-induced neutropenia. CT scanning was diagnostic in six patients thought to have typhlitis. Two patients were not diagnosed before exploratory laparotomy. The authors have found nonoperative treatment highly effective in patients who do not manifest signs of peritonitis, perforation, gastrointestinal hemorrhage, or clinical deterioration. Recurrent typhlitis was frequent after conservative therapy (recurrence rate, 67 percent), however. One patient underwent an elective right hemicolectomy after a second episode, and typhlitis did not recur despite neutropenia associated with a subsequent course of chemotherapy. It is concluded that successful treatment of this disease hinges on: 1) early diagnosis provided by a high index of suspicion and the use of CT scanning, 2) nonoperative treatment for uncomplicated cases, and 3) elective right hemicolectomy to prevent recurrence.
Dis Colon Rectum 1989 Mar
PMID:Recurrent typhlitis. A disease resulting from aggressive chemotherapy. 292 Jun 27

In a review of 1037 patients with colorectal cancers, there were 32 patients below the age of 40 years (3 percent). Rectal bleeding and abdominal pain were the most common presenting symptoms. The average delay between the onset of symptoms and treatment was 6.5 months. An analysis of tumors according to Dukes' staging revealed no significant difference between young and elderly patients. The younger patients had a greater frequency of mucinous and poorly differentiated carcinoma. When compared by clinical staging, however, the young patient did as well or better than his older counterpart. Clinical staging was the most important prognostic factor, irrespective of age. No inherent difference was found in the virulence of the cancer in the young, and five-year survival rates were not significantly different in young and old patients (59 percent vs. 49 percent).
Dis Colon Rectum 1986 May
PMID:Colorectal cancer in patients under 40 years of age. 300 8

Primary malignant lymphoma of gastrointestinal tract is relatively rare and the most of it are seen in stomach or small intestine, and in Japan only 130 cases of primary large intestinal malignant lymphoma were reported from the accumulating results of the postoperative cases in the 11th Congress of the Japanese Research Society for Cancer of the Colon and Rectum. This paper describes the case report of the primary malignant lymphoma originated from the cecum, and the review of the literature. The patient was 63 year-old female, who came to this hospital for slight fever and right lower abdominal pain that was gradually increasing. After the investigation by using barium enema and the intrapelvic CT, cecum tumor was detected. The ileocecal excision was performed, and revealed the 4 X 4.5 cm tumorous type lesion of which surface was slightly irregular. Histopathologically the tumor was follicular lymphoma (partial type), medium sized cell type by the Lymphoma-leukemia Study Group (LSG) classification. After discharge, cyclophosphamide was administered by 100 mg/day for six weeks, and the sign of the recurrence has not been observed.
 ...
PMID:A case of large intestinal malignant lymphoma. 306 92

Polyethylene glycol electrolyte lavage solution was compared with a 10 percent mannitol solution for preoperative colonic cleansing. Eighty patients were prepared randomly with one of these solutions on the afternoon prior to surgery. Colonic cleansing was better with polyethylene glycol electrolyte lavage (90 percent optimal cleansing vs. 75 percent). Analysis of hematologic, biochemical, and weight changes before and after the bowel preparation, demonstrated a mild subclinical dehydration with the use of mannitol. Evaluation of patient tolerance demonstrated more nausea, cramps, and abdominal pain with mannitol. Other symptoms were similar with both preparations. Colonic hydrogen gas was sampled during surgery, and two patients in the mannitol group had combustible levels. This study confirms that both 10 percent mannitol and polyethylene glycol electrolyte lavage are safe, effective methods of preoperative bowel cleansing. Better cleansing, patient tolerance, and lower hydrogen gas level make polyethylene glycol electrolyte lavage the preferred method.
Dis Colon Rectum 1986 Nov
PMID:Comparison of oral lavage methods for preoperative colonic cleansing. 309 80


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