Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case of empyema of the gallbladder in a eight year old child is reported. The child presented simptoms relatively constant in the hydrops of the gallbladder, nomely abdominal pain usually confined to the right upper quadrant and or epigastrium, fever, nausea, vomit, dehidratation; a tender abdominal mass was palpable. As usually occurs in childhood, the acute distension of the gallbladder followed in this report, to preceding focus of infection (angina and cervical lymphadenopathy). Ultrasonography permitted to address the correct diagnosis. This was later confirmed at surgery and from histopathologic study.
 ...
PMID:[Empyema of the gallbladder in an 8-year old boy]. 639 30

The 564 consultations performed by a general medicine consultation service during its first year were analyzed in order to provide a concrete definition of this new academic domain. Of the consultations, 52 percent were for patients on the surgical service. Among these patients, the most common reason for consultation was the preoperative management of chronic illness, specifically, hypertension, diabetes, and angina; 47 percent of such patients had two or more chronic illnesses. The service recommended cancellation of planned surgery in 2 percent and postponement in 9 percent of the 210 patients seen preoperatively. Patients on the psychiatric service accounted for 47 percent of the consultations. In this group, diagnostic issues were the most common reasons for consultation, that is, abdominal pain, dementia, and the suspicion of thyroid disease. Only 12 percent of the patients were seen for prognostic reasons, usually related to the planned use of electroconvulsive therapy or tricyclic antidepressants. The service was evaluated by the referring physicians who rated the service favorably on its "mechanics," as well as on its qualitative performance. However, complaints of triviality were voiced when the average length of the list of recommendations seemed disproportionate to the complexity of the problems. The service was also evaluated by the residents who had provided consultations. From their perspective, the service was more successful in teaching the "art" of consultation than the "science." This experience provides an operational definition of the work facing a general medicine consultation service as well as data useful in focusing future educational programs and research efforts.
 ...
PMID:General medicine consultation. Lessons from a clinical service. 685 76

Sclerosing peritonitis developed in a 56-year-old white man who had been receiving propranolol (320 mg/day) for hypertension and angina pectoris since December 1976. The patient had abdominal pain, loss of weight, pleural effusion, and gastrointestinal hemorrhage. Laparotomy revealed extensive adhesions which were so remarkable that the organs were fixed. Infectious and neoplastic causes of fibrosing peritoneal inflammation were excluded. To my knowledge the development of sclerosing peritonitis with extensive colonic involvement and colonic hemorrhage has been been described previously with therapy with propranolol.
 ...
PMID:Sclerosing peritonitis and propranolol. 697 Jun 57

DT, a 63-year-old white male with insulin-dependent diabetes mellitus and severe peripheral vascular disease, was admitted with a five-day history of vague abdominal pain and diarrhea. On the day of admission he vomited three times, was noted to have a bloody stool, and came to the emergency room. DT denied hematemesis, fever, or chills. He had bilateral leg amputations and had sustained three myocardial infarctions, the last one 15 months before this admission. He had never experienced symptoms of abdominal angina. Of significance was his history of congestive heart failure, mitral regurgitation, and atrial fibrillation. His medications on admission included digoxin 0.25mg per day, furosemide 40mg per day, and NPH insulin 15 units per day. On admission to the hospital his oral temperature was 38 degrees C, pulse was 90/min, respiratory rate was 24/min, and blood pressure was 134/80mmHg. Abdominal examination revealed a distended abdomen with hypoactive bowel sounds and mild tenderness. Chest x ray revealed cardiomegaly. The electrocardiogram demonstrated atrial fibrillation. A plain film of the abdomen was positive for gallstones and edema of the bowel wall (thumb-printing). Laboratory results included blood urea nitrogen 48mg%, creatinine 1.2mg%, hemoglobin 18g/dl, and hematocrit 52.9%. White blood cell count was 11,900 cells/cc with 33% polymorphonuclear leukocytes, 47% bands, 8% lymphocytes, 11% monocytes, and 1% atypical lymphocytes. The prime considerations for differential diagnosis were mesenteric ischemia and infectious gastroenteritis. While it was appreciated that mesenteric ischemia, if present, might warrant surgical intervention, the risk of anesthesia itself in this patient was felt by his attending physicians to exceed 30%. Furthermore, the clinical findings were only "suggestive" of mesenteric eschemia. They were certainly not "diagnostic." In view of this dilemma, a consultation with the Division of Clinical Decision Making was requested.
 ...
PMID:Abdominal pain, atherosclerosis, and atrial fibrillation. The case for mesenteric ischemia. 716 38

Five cases of pathologic rupture of the spleen in patients with hematologic malignancy are presented along with a review of the 48 cases previously described in the English literature. Pathologic splenic rupture occurred most commonly in patients with acute leukemia but has been well documented in chronic leukemias and in lymphoma as well. Nearly all patients experience abdominal pain at the time of rupture; however, this pain was frequently confused clinically with that of biliary tract obstruction, aortic aneurysm, perforated viscus, pancreatitis, and angina pectoris. Pain referred to the left shoulder (Kehr's sign) was present in only 17% of patients. Hypotension was documented in 66%, fever in 74%, and tachycardia in 75%. The most effective diagnostic procedure was paracentesis, which confirmed intraabdominal hemorrhage in each of the nine cases in which the procedure was used. A correct preoperative diagnosis of splenic rupture was reported in only 10 of the 53 cases reviewed. Fifty-two percent of the patients underwent laparotomy; 48% died without operation. Of those that underwent surgery, 78% survived the procedure and the immediate postoperative period. The survival rate of all patients was 38%. There was no correlation of the type of hematologic malignancy, occurrence or type of treatment, peripheral blood counts, or spleen size to survival. The most important factor in predicting survival was appropriate surgery.
 ...
PMID:Splenic rupture in patients with hematologic malignancies. 730 28

Since the turn of the century, recurrent abdominal pain (RAP) has been a diagnostic dilemma. From the fifties, the work of Apley led to a shift in the thinking i.e., away from organic to psychosomatic causes for the pain. During the past decade, however, better gastroenterological studies have led to a return to a search for organic causes. Psychologically, this may prove salutory to the child with RAP. Based on the history, glucose tolerance and histopathological studies reported elsewhere by the authors, it is suggested that the pain in these children is due to intestinal angina. The angina may be consequent to the master switch of life operating as a glucose homeostatic mechanism in mild viral infections. The role of intravenous glucose in such situations is discussed.
 ...
PMID:Pathogenesis and rationale of treatment of recurrent abdominal pain. 734 67

Percutaneous transluminal dilatation of an atherosclerotic stenosis of the superior mesenteric artery was done in a 65-year-old woman with abdominal angina. The patient was relieved of abdominal pain immediately after the dilatation.
 ...
PMID:Treatment of abdominal angina with percutaneous dilatation of an arteria mesenterica superior stenosis. Preliminary communication. 737 Oct 46

The syndrome of abdominal angina is described in three patients receiving long-term hemodialysis. This clinical entity has not yet been described in patients with chronic renal failure. The classic triad of abdominal pain, weight loss, and diarrhea produces fear of eating. Most laboratory and radiologic investigations are inconclusive. Remarkable relief of symptoms occurs with maintenance of the hematocrit level above 30%, reduction of pump speed during hemodialysis to approximately 200 ml/min, use of a smaller surface area dialyzer, and administration of sublingual nitroglycerin. This clinical syndrome is often misdiagnosed, resulting in several unnecessary investigations, as well as unnecessary surgical procedures. Cholecystectomy is the operation most commonly done. All three of our patients died within ten months of diagnosis.
 ...
PMID:Abdominal angina in patients receiving long-term hemodialysis. 746 33

The maintenance of angina control was assessed in this multicenter (three sites), randomized, double-blind, parallel-group study. Patients with stable angina pectoris receiving twice-daily sustained-release (SR) diltiazem were switched to equivalent doses of once-daily controlled-delivery (CD) diltiazem or to diltiazem SR. Patients who were switched from diltiazem SR to diltiazem CD (n = 28) experienced a 5% increase in time to termination (p = 0.0004) on the exercise tolerance test (ETT), as well as an 8% improvement in time to onset of angina (p < 0.0001) on the ETT. A similar trend was observed in patients randomized to diltiazem SR (n = 7), which suggested a training effect, and, therefore, equal efficacy between diltiazem SR and diltiazem CD. During exercise testing in the diltiazem SR baseline phase, 77% of the patients did not experience angina, whereas 60% of the patients did not experience ST-segment depression. Following transfer to diltiazem CD, 79 and 61% of patients, respectively, remained angina- and ST-segment depression free. No significant changes in the number of angina attacks, nitroglycerin use, or any hemodynamic-related parameters were observed following transfer to diltiazem CD. Eleven percent of the patients receiving diltiazem CD experienced treatment-related adverse events, which were limited to headache and abdominal pain; these adverse events did not lead to discontinuation of treatment. These findings suggest that patients whose angina is controlled with twice-daily diltiazem SR can be safely and effectively switched to an equivalent daily dose of the once-daily diltiazem CD.
 ...
PMID:Clinical efficacy and safety of once-daily diltiazem in patients with stable angina pectoris switched from twice-daily diltiazem. 756 71

A 66-year old woman had had intermittent anterior chest pain and upper abdominal pain for 15 years. Angina pectoris was diagnosed at the age of 51 years, as she had typical anginal pain that was relieved by nitroglycerine, although coronary arteriography was normal and the ergonovine provocative test was negative. She had undergone cholecystectomy at the age of 38 years. Her bile duct pressure increased markedly after morphine injection and severe pain with the aforementioned distribution was produced. Postcholecystectomy syndrome due to sphincter of Oddi spasm was diagnosed and her pain was relieved by endoscopic sphincterotomy.
 ...
PMID:Postcholecystectomy syndrome mimicking angina pectoris detected by the morphine provocation test. 771 81


<< Previous 1 2 3 4 5 6 Next >>