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

A 77-year-old man with diabetes mellitus presented with a 2-month history of lumbago radiating to the right lower limb as well as high fever spikes. Physical examination revealed a distended abdomen with right lower quadrant tenderness. A computed tomographic scan of the abdomen revealed a large right retroperitoneal cavity containing an air-fluid level that was consistent with a gas-producing abscess. The patient began receiving intravenous antibiotics, but fever and abdominal pain persisted and a large, fluctuating, tender swelling appeared on the medial aspect of his right thigh and right calf. The patient underwent surgical exploration: a right lateral abdominal incision was performed, and the pus collection in retroperitoneal space was completely evacuated. We also made 3 separate incisions on the medial aspect of the right thigh and 1 incision on the upper calf, resulting in the drainage of pus. The patient made a slow but steady recovery.
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PMID:Primary retroperitoneal abscess extending to the calf. 1636 48

It has recently been noted that screening for depression can improve clinical outcomes. The purpose of the present study was to examine whether somatic symptoms reported at health examinations predicted depression in the following year. Subjects were 1066 Japanese workers (732 men, mean age 35 years) attending annual health examinations at an institute in two successive years. A self-administered questionnaire including items of 12 major somatic symptoms was given to all the subjects. Then clinical interviews of the DSM-IV were used to diagnose major depression and minor depression in both years. In addition, the 17-item Hamilton Depression Scale (HDS-17) was measured as one of the outcomes of depression in the following year. The prevalence of major (minor) depression was 3.7 (7.8)% at baseline and 3.4 (5.9)% for the following year, respectively. The following year's HDS-17 scores were higher (all P < 0.05) in those who had complained of each somatic symptom at baseline than in those who had not. Three somatic symptoms (low back pain, dizziness, and abdominal pain) at baseline were significant risk factors of major depression for the following year. Dizziness at baseline significantly predicted major and minor depression for the following year as well. Somatic symptoms may be good predictors to screen for depression at health examination.
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PMID:Somatic symptoms for predicting depression: one-year follow-up study in annual health examinations. 1659 47

A 61-year-old white man was admitted to our department because of severe back and upper abdominal pain of 1 month's duration. The patient was diagnosed with Wegener granulomatosis 10 months before the presentation based on chronic otitis media, hoarseness, and hemoptysis; positive c-ANCA; and laryngeal and lung biopsies showing multinucleated giant cells. The patient was treated with monthly injections of cyclophosphamide (1-1.5 g per month) and 80 mg prednisone daily with rapid improvement. Prednisone dose was tapered off and 1 month before the present admission, the patient developed severe low back pain. Extensive workup, including abdominal computed axial tomography scan, computed tomography angiography, magnetic resonance image of the spinal cord, and fluorodeoxyglucose-positron emission tomography (FDG-PET) scan, revealed 2 periaortic soft tissue structures seen at the level of L3 and at the level of the celiac trunk and linear meningeal thickening of the spinal cord at the level of D4-8. All these structures showed strong signal on FDG-PET scan. Treatment with methylprednisolone (1000 mg/d) for 3 consecutive days followed by 80 mg prednisone per day and 100 mg cyclophosphamide per day was started with rapid attenuation of the patient's symptoms. This case describes the clinical course of the rare complication of Wegener granulomatosis, periaortitis, and dural inflammation despite monthly cyclophosphamide and demonstrates the role of magnetic resonance imaging and FDG-PET in their diagnosis.
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PMID:Wegener granulomatosis with back pain, periaortitis, and dural inflammation developing while receiving monthly cyclophosphamide. 1714 61

Low back pain (LBP) is defined as pain localised between the 12th rib and the inferior gluteal folds, with or without leg pain. Most cases are non-specific, but in about 10% of cases a specific cause is identified. Red flags are typical signs or symptoms that are frequently associated with specific LBP. Yellow flags are prognostic factors associated with a more unfavourable and often chronic disabling course of the disease. LBP has a lifetime prevalence of 60-85%. At any one time, about 15% of adults have LBP. LBP poses an economic burden to society, mainly in terms of the large number of work days lost (indirect costs) and less so by direct treatment costs. A substantial proportion of individuals with chronic LBP has been found to have chronic widespread pain. LBP is often associated with other pain manifestations such as headache, abdominal pain and pain in different locations of the extremities. Widespread pain is associated with a worse prognosis compared to localised LBP. Treatment targets are reduction of pain and better activity/participation, including prevention of disability as well as maintainance of work capacity. The evidence from selected and appraised guidelines, systematic reviews and major clinical studies was classified into four levels, level Ia being the best level with evidence from meta-analysis of randomised controlled trials. Key recommendations (level Ia): fitness programmes and advice to stay active can reduce pain, improve function and can prevent LBP becoming chronic. Simple analgesics, NSAIDs and muscle relaxants can reduce pain and can improve and maintain function. Maintaining physical activity, avoiding rest and manual therapy can reduce pain and maintain and restore function in acute LBP. Behavioural treatment can prevent LBP becoming chronic. Aerobic fitness and endurance training, behavioural treatment and multi-disciplinary treatment programmes can reduce pain and can improve/maintain function in chronic LBP.
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PMID:Strategies for prevention and management of musculoskeletal conditions. Low back pain (non-specific). 1735 May 45

Renal medullary carcinoma (RMC) is an aggressive neoplasm occurring almost exclusively in adolescents and young adults with sickle cell (SC) hemoglobinopathies, usually sickle cell trait (SCT) or hemoglobin SC disease. The most common presentations are hematuria and flank or abdominal pain. It is a highly malignant tumor, and responses to chemotherapy are rare and transient resulting in a dismal prognosis. A high level of suspicion is necessary when evaluating at risk patients presenting with hematuria or flank pain, as currently it appears that only early diagnosis could potentially alter the outcome of this disease. We report a case of RMC in a young male patient with SCT, who presented to the emergency department with low back pain and microscopic hematuria, clinically mimicking acute obstructing urolithiasis. Our case emphasizes the need to consider alternate diagnoses when evaluating computed tomography scans for acute flank pain.
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PMID:Renal medullary carcinoma: unsuspected diagnosis at stone protocol CT. 1740 14

Spontaneous aortocaval fistula is a rare complication of abdominal aortic aneurysm rupture. A definitive preoperative diagnosis sometimes is difficult, because ofnonspecific and highly variable clinical symptoms. Classic signs such as low back pain, palpable pulsatile abdominal mass, abdominal bruit and thrill, dyspnea and high-output cardiac failure are present in less than 50% of cases. In this article we report the case of a 68-year-old patient with an aortocaval fistula who was admitted in hospital because of abdominal pain and hematuria.
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PMID:[Spontaneous aortocaval fistula]. 1755 49

An 83-year-old woman was admitted to hospital with complaints of fever, abdominal pain and other complaints suggesting urosepsis. Additional analyses did not reveal the cause of her complaints. After cessation of antibiotic therapy, there was a spontaneous decrease in the infection parameters and she was subsequently discharged. Two and a half months later she was presented in our hospital with low back pain with radiating to the legs. MRI showed signs ofa spondylodiscitis at the level of LIII-LIV existing for some time. Finally, a gram-positive streptococcus infection was found and she was treated with antibiotics for 13 weeks. 6 months later she was free of symptoms. A 57-year-old man was admitted to the intensive care with a double-sided olecranon bursitis and sepsis. An endocarditis caused by Staphylococcus aureus was thought to be the cause of the sepsis and the patient was treated with surgical intervention and antibiotics. Because of persistent sepsis, different CT-scans were performed, and after one and a half months an extensive spondylodiscitis with abscess formation was diagnosed and subsequently treated surgically. A delay in diagnosing spondylodiscitis is the rule rather the exception. The diagnosis should be considered in any patient with localised back pain, especially when accompanied by fever, high ESR, and the presence of risk factors such as high age, diabetes mellitus, immunosuppression, and/or rheumatoid arthritis.
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PMID:[Spondylodiscitis as cause of unexplained fever]. 1839

We report the clinical case of a 73-years-old woman with sarcoidosis since 29 years-old, on long-term corticosteroid therapy, who presented with symptoms of abdominal pain after an episode of acute and severe low back pain associated with significant functional impairment, in the context of D11 fracture. Although infrequent, recent spine fractures should be considered in osteoporotic or osteoporotic risk patients presenting with pain and abdominal distension.
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PMID:[Colonic acute pseudo-obstruction: uncommon manifestation of vertebral fracture]. 2008 69

Aortic dissection is a catastrophic illness that is a significant source of liability for hospitals if diagnosis and treatment are not done promptly. The diagnosis is often difficult to make because not all dissections have the typical presentation of sudden severe chest pain radiating to the back. Symptoms often include abdominal pain, flu-like complaints, vomiting and diarrhea, low back pain, stroke syndromes and syncope. Patients at risk include those with Marfan syndrome and other connective tissue diseases, familial aortic disease, age and hypertension. Aortic dissection is a different clinical entity than abdominal aortic aneurysm. Strategies to reduce risk and improve outcome include staff education on various presentations and risk factors, rapid availability of diagnostic testing modalities such as chest CT scan or transesophageal echocardiogram, and protocols to ensure prompt transfer for cardiothoracic surgery.
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PMID:Case studies in acute aortic dissection: strategies to avoid a catastrophic outcome. 2019 21

We describe a rare case of surgical treatment for a repeated contained rupture of an infected abdominal aortic aneurysm (AAA) with concomitant vertebral erosion. A 59-year-old man presented to a nearby hospital with abdominal pain and fever. On admission, computed tomography (CT) scan revealed a contained rupture of AAA, but the patient declined the offer of surgical therapy. Thereafter, the retroperitoneal hematoma gradually reduced in size. The third and fourth lumbar vertebrae were eroded on the CT scan 12 months after the appearance of the first symptom. However, 21 months after the first symptom, he suffered severe lumbago and was diagnosed with recurrence of contained AAA rupture and vertebral body destruction. He underwent debridement of eroded vertebrae and in situ graft replacement of AAA with omentum flap wrapping. Intraoperative microscopic examination of the hematoma revealed gram-positive Streptococcus. His postoperative course was uneventful, and CT 12 months after surgery did not reveal further deterioration of vertebral erosion or fluid accumulation. Repetitive contained AAA rupture may be another entity in contrast to chronic contained AAA rupture. Vertebral erosion could be associated with infection rather than mass effects of the contained hematoma. Surgical treatment is indicated to prevent life-threatening re-rupture and severe spinal instability.
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PMID:Repetitive contained rupture of an infected abdominal aortic aneurysm with concomitant vertebral erosion. 2047 95


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