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

During a 5-year period, 15 cases of primary gastrointestinal lymphoma, corresponding to 14% of the non-Hodgkin's lymphomas, were diagnosed in a population of 200,000. Most patients had a short duration of symptoms--less than 3 months--and a clinical picture dominated by abdominal pain. All patients were laparotomized and six patients presented with an acute abdomen and were subjected to emergency operations. In seven cases, gastrointestinal malignancy was not suspected preoperatively. The patients were treated with a combination of surgery, cytostatic therapy, and/or radiotherapy. Cases with localized disease had a favorable prognosis, seven of nine patients being alive 31 to 70 months after diagnosis. A statistically significant difference in median survival was also noted between patients with lymphomas of low-grade and high-grade malignancy (70+ vs. 10.5 months).
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PMID:Primary gastrointestinal lymphoma incidence, clinical presentation, and surgical approach. 378 59

A 66-year-old man presented after having been involved in a motor vehicle accident. He was not wearing his seatbelt, and his vehicle had a deformed steering wheel after the incident. In the emergency department, his only complaint was mild right lower quadrant abdominal pain without signs of rebound or guarding. His laboratory and radiologic evaluations were unremarkable and he was observed in the intensive care unit. Nine hours after the accident, he developed an acute abdomen; exploratory laparotomy revealed a perforation of the gall bladder. Gall bladder injuries secondary to blunt trauma are infrequent events.
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PMID:Perforation of the gall bladder following blunt abdominal trauma. 382 18

The clinical diagnosis of Spigelian hernia can be difficult due to lack of specific and constant findings. We report two patients whose only symptoms on presentation were progressive abdominal pain and intermittent palpable mass. The radiographic demonstration of bowel extending outside the expected confines of the peritoneal cavity allowed prompt diagnosis and proper operative management in both patients. Spigelian hernia requires surgical correction to prevent complications of acute abdomen with strangulation or incarceration.
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PMID:Spigelian hernia. 382 19

In a 26-year-old patient admitted to the emergency ward with acute abdomen, all the symptoms--nausea, vomiting, indeterminate abdominal pain, constipation, renal failure, polyuria and polydipsia--could be explained by calcium intoxication syndrome. Investigation revealed generalized sarcoidosis. Under medical treatment with prednisone all the pathologic findings rapidly regressed. The pathogenesis of hypercalcemia in sarcoidosis, and particularly the disorder of vitamin D metabolism with raised levels of 1,25-dihydroxycholecalciferol, are discussed.
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PMID:[Acute hypercalcemia syndrome in sarcoidosis]. 384 Sep 13

Primary mesenteric venous thrombosis is a rare disease and it is difficult to diagnose preoperatively. In this report, we present a case with interesting sonographic and computed tomographic findings. On March 15, 1984, a 53-year-old male was admitted to Central Hospital of Social Insurance because of intracranial hematoma, which was removed immediately. On May 17, the patient complained of a vague abdominal pain, in the left upper quadrant. Seven days later, the pain became severe and he was referred to our department. White blood cell count was 19300/mm3. On ultrasound and computed tomographic examination, a rigid thick-walled bowel loop was visualized. Laparotomy was performed and a gangrenous bowel loop (35cm long) was resected. Postoperative course was well. It should be emphasized that ultrasound and computed tomography are noninvasive and may be very helpful for differential diagnosis in the cases of acute abdomen.
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PMID:[A case of mesenteric venous thrombosis: its sonographic and computed tomographic findings]. 390 69

Acupuncture as a therapeutic measure for abdominal pain was early recorded in Huangdi Neijing ("Yellow Emperor's Canon of Medicine"). Fruitful experiences have been accumulated in the practice of the long historical years. Nowadays acupuncture therapy has become one of the main therapeutic methods in surgical acute abdomen and is widely used clinically.
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PMID:Acupuncture therapy in acute abdomen. 402 7

This paper presents the clinical features of 600 patients suffering from abdominal pain of acute onset and admitted to either the General Infirmary or St. James's Hospital, Leeds. The survey was initially retrospective, but later put on a prospective basis. Roughly two-thirds of these 600 patients presented a "typical" picture of the disease with which they presented, while the remaining third presented one or more atypical features. Since other prospective studies have indicated that the diagnostic accuracy of a group of clinicians in respect of the acute abdomen is roughly 65% it is tentatively suggested (a) that clinical diagnosis contains a large element of "pattern-matching," and (b) that such a policy can be expected to be ineffective in roughly one-third of all cases of acute abdominal pain.
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PMID:Clinical presentation of acute abdomen: study of 600 patients. 450 71

The records of 106 consecutive patients referred to the University of Colorado Medical Center (UCMC) vasculitis study group during a 5-yr period were evaluated for gastrointestinal (GI) manifestations attributable to vasculitis. There were 3 groups: 18 with leukocytoclastic vasculitis (LCV) on skin biopsy younger than 16 yr of age; 75 with LCV older than 16 yr of age; and 13 with polyarteritis nodosa (PAN). Significant GI manifestations at presentation or exacerbation of vasculitis occurred in 38 of 106 (36%) patients. These were more frequent in LCV patients younger than 16 yr (66%), than older LCV patients (26%) or PAN patients (46%). The commonest complaint was abdominal pain (79%), followed by nausea (63%), vomiting (37%) and diarrhea (23%). GI bleeding was present in 52% and acute abdomen in 21% of patients. No consistent radiologic findings were noted. Duodenal and peritoneal biopsies suggested vasculitis in 6 LCV patients. Seven exploratory laparotomies were performed in 4 LCV and 3 PAN patients. Intestinal infarction was found in 3 patients with PAN, but in one of the LCV patients. Two patients with LCV with an acute abdomen were not explored and responded promptly to iv corticosteroids. Thus, systemic vasculitis frequently involves the GI tract. In patients with LCV, recognition of this association and treatment with corticosteroids can avoid surgery. In our patients with PAN, however, acute abdominal signs indicated infarction requiring surgery and resection.
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PMID:Gastrointestinal involvement in leukocytoclastic vasculitis and polyarteritis nodosa. 610 71

Between 1974 and 1978 we saw nine patients with acute gastro-duodenal ulcers. Morphologically these were characterised by their unusual extent without deep penetration, by sharp bizarre contours, and with symmetrical findings in the gastric antrum. Spasm and submucous inflammatory reactions may obscure the niche of an antral ulcer and lead to stenosis and rigidity; in the differential diagnosis an infiltrating carcinoma must be excluded. This is possible by double contrast demonstration of the ulcer en face. The clinical picture is one of sudden, severe upper abdominal pain with features of an acute abdomen, often with a previous history of stress or of gastric distension with vomiting.
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PMID:[Acute gastro-duodenal ulceration--lesions without a niche (author's transl)]. 645 96

Because bleeding into the rectus sheath may give a clinical picture simulating an acute abdomen, it is essential that an accurate diagnosis be made so that an unnecessary laparotomy is not performed. Plain films do not give adequate information and computerized axial tomography is not always available, but ultrasonography, which is noninvasive and is readily available, provides an accurate diagnosis as in the case reported in this paper. A 57-year-old woman had bilateral hematomas of the rectus sheath that did not occur simultaneously. She had a chronic debilitating disease as do the majority of such patients. Long-term cortisone therapy with secondary breakdown of connective tissue was probably the predisposing factor. During a blood transfusion that was needed following operation for osteomyelitis the patient had a severe reaction accompanied by sudden onset of severe abdominal pain on the left side. Ultrasonography confirmed the tentative diagnosis of rectus sheath hematoma. The patient was treated conservatively. The pain subsided within a few days leaving an ecchymosis. Two weeks later she experienced a similar pain on the right side which was also diagnosed by ultrasonography as a rectus sheath hematoma. Again, with conservative treatment the pain subsided leaving discolouration of the skin. The authors stress the value of ultrasonography in diagnosing rectus sheath hematoma and the importance of conservative management.
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PMID:Ultrasonography in the diagnosis of rectus abdominis hematoma. 645 3


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