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

Necrotizing lesions of the colon occur in patients with malignancy. We identified 26 patients with cancer (23 with acute leukemia and three with solid tumors) who died from necrotizing colitis. Autopsies revealed three pathologic categories: pseudomembranous colitis in 69 per cent, agranulocytic colitis in 19 per cent and ischemic colitis in 12 per cent. Most died from sepsis. A comparison of characteristics was made with a control population matched for diagnosis, age, cause of death and duration of neoplasia. Nearly all patients in both groups had fever and were granulocytopenic secondary to chemotherapy. Most received antineoplastic and antimicrobial regimens during the month prior to their terminal illness. Abdominal pain and distention, stomatitis and necrotizing pharyngitis were frequently associated with colitis. Hyperbilirubinemia was a frequent late complication in those with colitis and the control group. Single and multiorganism septicemia were found more frequently in patients with colitis. As antemortem diagnosis was unusual, aggressive attempts at diagnosis are necessary to assess the true incidence of this disorder and the best therapy.
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PMID:Necrotizing colitis in patients with cancer. 49 35

Two cases of pseudomembranous colitis, one associated with administration of ampicillin and the other associated with administration of ampicillin and trimethoprim-sulfamethoxazole, are reported. Both patients presented with diarrhea, abdominal pain, fever and an elevated leukocyte count. Pseudomembranous colitis was diagnosed by sigmoidoscopy and biopsy. Both patients recovered with conservative management.
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PMID:Antibiotic-associated pseudomembranous colitis. 60 48

Twenty-eight patients with histologically proved pseudomembranous colitis have been seen in one hospital since July 1975. All patients with the disease had received antibiotics, six for infections not requiring operations; the other 22 cases all occurred after major surgery. All the patients had diarrhoea; six patients also had fever with clinical signs of sepsis, and three had abdominal pain thought to be due to anastomotic dehiscence after colonic resection. Pseudomembranous colitis was associated with white blood counts over 15 000/mm3 in 17 patients and albumin concentrations of less than 30 g/1 in 18. Pseudomembranous colitis was an incidental finding at necropsy in two of six patients who had not had an operation. Of the 22 patients who had had major surgery, nine died from this complication; in all except two of these cases the diagnosis was made only at necropsy. If pseudomembranous colitis is suspected on clinical grounds or if there is an unexplained complication after colorectal surgery repeat sigmoidoscopy and testing for faecal toxins should be carried out to establish the diagnosis so that prompt supportive treatment can be given.
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PMID:Diagnosis of pseudomembranous colitis. 63 Feb 92

Five cases of pseudomembranous colitis (PMC) provided the opportunity for observation of clinical, endoscopic, and histologic features, and evaluation of potential modes of therapy. Although PMC may occur postoperatively or concomitantly with staphylococcal infection, if most frequently occurs following the administration of a variety of antibiotics. Patients with this disorder often have chronic, debilitating diseases. The clinical course may vary from a self-limited diarrheal illness to a fatal process. Onset with abdominal pain, diarrhea, and fever is characteristic. Barium enema contrast findings are nonspecific. Proctoscopy usually permits an accurate diagnosis. In the typical case, multiple elevated nodules formed by cream-colored plaques of pseudomembrane are scattered about the inflamed mucosa. Biopsy of these nodular lesions will confirm the diagnosis. Therapy must be individualized.
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PMID:Clinical spectrum of pseudomembranous colitis. 94 58

Pseudomembranous colitis secondary to antibiotic therapy has received increasing recognition. During a one-year period, eight of 42 patients with this entity had findings closely resembling an acute surgical condition of the abdomen manifested by fever, leukocytosis, and severe abdominal pain and tenderness. All eight patients received clindamycin and two were also given lincomycin hydrochloride monohydrate. Differentiation from an acute surgical condition of the abdomen was difficult until the characteristic findings of pseudomembranous colitis were noted on proctoscopic examination. Unnecessary celiotomy was averted in all patients. Seven of eight patients responded to discontinuation of the antibiotic and supportive measures; one required a diverting ileostomy. Drug-induced colitis must be an important consideration in any patient recently receiving antibiotics who develops fever, abdominal pain, and diarrhea.
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PMID:Drug-induced colitis mimicking an acute surgical condition of the abdomen. 113 Sep 91

Clostridium difficile-associated pseudomembranous colitis is an increasingly common nosocomial infection that usually responds to oral antibiotics. Presentation as an acute abdomen occurred in 12 patients, leading to 14 laparotomies. A distinctive clinical picture was observed: advanced age, recent treatment with antibiotics, fever, abdominal pain, tenderness, marked leukocytosis, and ileus. Only six of the 12 patients had diarrhea. Five were immunosuppressed. Abdominal computed tomographic scans revealed ascites and a massively thickened colonic wall. All four patients treated by subtotal colectomy survived. Four of 10 patients treated only with laparotomy or segmental colectomy died, four responded to medical therapy, and the conditions of two deteriorated but were salvaged by subtotal colectomy. Early diagnosis via endoscopy or computed tomography should obviate the need for exploratory operations. However, progressive toxic effects indicate failure of medical therapy and the need for subtotal colectomy.
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PMID:Laparotomy for fulminant pseudomembranous colitis. 152 85

Myxedema megacolon is rare; usually, it manifests with abdominal distention, flatulence, and constipation. Herein we describe a 72-year-old man who had intermittent diarrhea, bloating, and abdominal pain for more than a year. Cultures of stool specimens for Clostridium difficile enterotoxin were variably positive and negative. Colonoscopic biopsy specimens were thought to be consistent with chronic ischemia. Thyroid function tests showed severe hypothyroidism; the patient's symptoms resolved with thyroid hormone replacement. We hypothesize that gross dilatation of the colon, attributed to myxedema, was followed by intestinal ischemia and complicated by recurrent episodes of pseudomembranous colitis. A review of the relevant literature is provided. This unusual manifestation of myxedema should be considered in the differential diagnosis when a patient has diarrhea, bloating, and abdominal pain.
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PMID:An unusual case of myxedema megacolon with features of ischemic and pseudomembranous colitis. 154 53

Clostridium difficile has been well known to be a pathogen of pseudomembranous colitis. It is characterized by the formation of elevated plaques and pseudomembranes which result in varying degree of diarrhea. This series analysed 20 cases of pseudomembranous colitis diagnosed at Chang Gung Memorial Hospital between January 1985 and December 1989. The male to female ratio was 1:3. Their ages ranged between 13 and 81 years, with a mean of 53.7 years. Sixteen of our patients claimed to have taken antibiotics for upper respiratory tract infection, pneumonia, cellulitis or acute pelvic inflammatory disease within six weeks before onset of symptoms. The antibiotics were mainly in the penicillin group and cephalosporin group. Clinical presentations included diarrhea of varying degree, fever, and abdominal pain. The diagnosis was made by the typical colonic mucosal changes under sigmoidoscopic or colonoscopic examination and pathological findings. The lesions were prominent in the rectum and sigmoid colon. Eleven cases were treated with vancomycin. Of these, one failed and died, and two recurred. The two recurrences were again treated with the same dose of vancomycin and with complete remission. Three of our patients responded to metronidazole. The other six cases with milder symptoms were successfully controlled by using cholestyramine (2 cases) or by supportive treatment (4 cases).
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PMID:[Pseudomembranous colitis: a clinical analysis and review of literatures]. 187 12

During a 31-month period, evidence of gonadal vein thrombosis (GVT) was demonstrated by computed tomography (CT) in seven patients who had a broad spectrum of acute gastrointestinal inflammatory lesions, including diverticulitis, ulcerative colitis, Crohn disease, appendicitis with abscess, and perforated appendix with pseudomembranous colitis. All patients had lower abdominal pain, tenderness, fever, and leukocytosis. CT demonstrated thrombus through the length of the gonadal vein in each patient; the entire lumen of the vein was filled. No symptoms relating to GVT were present. GVT may resolve with treatment of the underlying enteric disease alone, and anticoagulant therapy may not be necessary.
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PMID:Gonadal vein thrombosis in patients with acute gastrointestinal inflammation: diagnosis with CT. 205 75

Four days after beginning a perioperative antibiotic prophylaxis with amoxicillin and clavulanic acid a 33-year-old patient developed an acute haemorrhagic diarrhoea with cramp-like lower abdominal pain. Coloscopy revealed diffuse mucosal oedema with map-like ulcerations, increased susceptibility to trauma and submucous haemorrhages extending from the middle of the ascending to the middle of the descending colon. Granulocytic inflammation with cryptal atrophy was seen histologically. Stool cultures, including tests for Clostridium difficile toxin, were normal. All symptoms disappeared within three days of discontinuing the medication. Coloscopy after one week revealed marked improvement, after three months nothing abnormal. Acute segmental haemorrhagic penicillin-associated colitis is rare and must be distinguished from antibiotic-associated pseudomembranous colitis.
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PMID:[Acute segmental hemorrhagic penicillin-associated colitis]. 200 46


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