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

Primary colonic adenocarcinoma and synchronous rectal carcinoids are rare tumors. Whenever a synchronous tumor with a nonmetastatic carcinoid component is encountered, its prognosis is determined by the associate malignancy. The discovery of an asymptomatic gastrointestinal carcinoid during the operative treatment of another malignancy will usually only require resection without additional treatment and will have little effect on the prognosis of the individual. This article reports a synchronous rectal carcinoid in a patient with hepatic flexure adenocarcinoma. We present a case of a 46-year-old Hispanic woman with a history of hypothyroidism, uterine fibroids and hypercholesterolemia presenting with a 2-week history of intermittent abdominal pain, mainly in the right upper quadrant. She had no family history of cancers. Physical examination was significant for pallor. Laboratory findings showed microcytic anemia with a hemoglobin of 6.6 g/dl. CT abdomen showed circumferential wall thickening in the ascending colon near the hepatic flexure and pulmonary nodules. Colonoscopy showed hepatic flexure mass and rectal nodule which were biopsied. Pathology showed a moderately differentiated invasive adenocarcinoma of the colon (hepatic flexure mass) and a low-grade neuroendocrine neoplasm (carcinoid of rectum). The patient underwent laparoscopic right hemicolectomy and chemotherapy. In patients diagnosed with adenocarcinoma of the colon and rectum, carcinoids could be missed due to their submucosal location, multicentricity and indolent growth pattern. Studies suggest a closer surveillance of the GI tract for noncarcinoid synchronous malignancy when a carcinoid tumor is detected and vice versa.
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PMID:Synchronous Adenocarcinoma of the Colon and Rectal Carcinoid. 2792 Jun 48

Hemolymphangioma is a benign tumor resulting from the abnormal development of the lymphatic vessels associated with vascular malformations. 50% to 60% of these tumours are present at birth. Cervical forms are most frequent. Abdominales locations are very rare. We report, through a literature review, two cases of patients with cystic hemolymphangioma of the spleen revealed by spontaneous haemoperitoneum admitted to the Emergency Department of Visceral Surgery. The first case is a 50-year old patient and the second is 20-year old man admitted to the emergency department with diffuse abdominal pain associated with dullness to percussion on the dependent side and abdominal distension associated with haemorrhagic shock, pallor, unobtainable pulse, stabilized after a short resuscitation time respectively. All patients underwent complete tumor resection. The diagnosis of cystic hemolymphangioma of the spleen was based on anatomopathological examination of the surgical specimens. Hemolymphangioma is a rare tumor with a favorable prognosis. Some cases of spontaneous regression have been reported, but evolution is usually characterized by slow tumor growth. Malignant transformation never occurs. Treatment is surgical. Prognosis is subjected to complications, quality of the surgical excision and recurrences which are frequent especially after incomplete excision.
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PMID:[A rare cause of spontaneous hemoperitoneum in adults: ruptured cystic hemolymphangioma]. 2845 Sep 87

Clinical and hematological parameters in six cases of paroxysmal nocturnal hemoglobinuria (PNH) are presented. The mean delay in diagnosis after onset of symptoms was 3.7 years. Initial diagnoses considered were: (a) hematuria; (b) iron-deficiency; hemolytic; megaloblastic or refractory anemia and (c) myelodysplastic syndrome. Clinical features included; reddish urine (5/6), unexplained abdominal pain (4/6) and pallor (6/6). Laboratory investigations showed anemia (6/6), leucopenia (3/6), thrombocytopenia (3/6), unconjugated hyperbilirubinemia at some stage (6/6), and bone marrow erythroid hyperplasia (6/6). Complications encountered were (a) gall stones needing cholecystectomy, hemosiderosis and proximal tubular acidosis in 1 case, (b) disseminated tuberculosis in 1 case and (c) abortion with congestive cardiac failure in one. PNH may present with atypical features and tests for hemosiderinuria, sucrose lysis test and HAM's test are required to establish the diagnosis.
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PMID:DIAGNOSTIC DILEMMAS IN PAROXYSMAL NOCTURNAL HEMOGLOBINURIA. 2876 56

Crytococcus neoformans is an encapsulated yeast that frequently affects immune-compromised patients, although increasingly being detected in the immune-competent host as well. We report a case of disseminated cryptococcosis in a young child in whom no immune deficiency was yet identified. A 4-year-old child presented with high-grade fever, intermittent abdominal pain and generalized skin eruptions for the past two months. He had pallor, firm lymphadenopathy, skin lesions with scarring and firm hepatosplenomegaly. Magnetic resonance imaging of brain and bone-marrow aspiration were normal. Fine-needle-aspiration-cytology of cervical lymph nodes demonstrated Cryptococcus. Serum latex-agglutination test showed a positive titer (1:256). Cryptococcus culture was sterile. The patient received intravenous liposomal amphotericin-B and oral flucytosine for 8 weeks followed by oral fluconazole. Disseminated cryptococcosis with involvement of reticuloendothelial and dermatological systems is rare. Early diagnosis and timely management of associated complications would be life saving.
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PMID:Systemic cryptococcosis in an immune-competent child. 2896 93

Intussusception may be difficult to diagnose because the classical triad of symptoms is evident at the time of presentation in only about 20% of cases. This may lead to delays in making the correct diagnosis. The most common presenting features are colicky abdominal pain, vomiting, pallor, lethargy and listlessness. In recent years, the algorithms of management of intussusception have changed significantly: a routine plain abdominal X-ray has been replaced by ultrasonography, previously perceived contraindications to attempting an enema reduction no longer apply, gas has largely replaced barium for enema reduction, incomplete initial reduction is an indication for a delayed repeat enema if the child is stable clinically and partial reduction has been achieved, the indications for surgery have been tightened and laparoscopy affords an alternative surgical approach. This commentary expands on the rationale behind some of the recent advances in the management of children who present with suspected intussusception.
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PMID:The 'ins' and 'outs' of intussusception: Where best practice reduces the need for surgery. 2914 3

Green tobacco sickness (GTS) is the condition that mainly affects the tobacco harvesters. The condition is prevalent in Asian and South American tobacco harvesters. The present review was conducted to discuss the etiology, epidemiology, symptoms, and prevention of GTS. It is caused by the absorption of nicotine through the skin while the workers are engaged in handling the uncured tobacco leaves. The symptoms include nausea, vomiting, pallor, dizziness, headaches, increased perspiration, chills, abdominal pain, diarrhea, increased salivation, prostration, weakness, breathlessness, and occasional lowering of blood pressure. The prevalence of GTS varies from 8.2 to 47% globally. The use of personal protective equipment like water-resistant clothing, chemical-resistant gloves, plastic aprons, and rain-suits with boots should be used by the tobacco farmers to prevent its occurrence. An international-level awareness campaign has to be taken up and more stringent workers safety regulations have to be formulated.
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PMID:Green Tobacco Sickness: A Brief Review. 2961 7

Segmental colitis associated with diverticulosis (SCAD) is manifested by active chronic inflammation of the colonic segments affected by diverticulosis, luminal-mucosal inflammation, independent of the presence of inflammation within and/or around the diverticula, and it usually spares the rectum. We present the case of a 15-year-old female admitted to our clinic due to lower digestive hemorrhage and abdominal pain in the previous week, associated with fever 1 day prior to admission. The patient had pallor, painful abdomen upon palpation, accelerated bowel movements, and macroscopic evidence of blood in the stools. Initial laboratory tests showed leukocytosis with neutrophilia, thrombocytosis, anemia, and elevated inflammatory biomarkers. Moreover, colonoscopy revealed multiple ulcerations, hemorrhage, and edema of the sigmoid colon; however, multiple orifices raised the suspicion of a colonic diverticulosis and this was later on confirmed through a barium enema. The histopathological examination pointed out signs of an active chronic inflammation and mucosal architectural changes associated with crypt abscesses, therefore suggesting the diagnosis of SCAD. The patient's prognosis was favorable; her condition improved following steroid and 5-aminosalicylate therapy, without any symptoms or recurrences at the 4 months follow-up. In conclusion, SCAD is a very rare disease entity that is usually confused with other inflammatory bowel conditions. Moreover, it has not been reported in the pediatric age group until now.
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PMID:Segmental Colitis Associated Diverticulosis-A Possible Diagnosis in Teenagers. 2992 40

Non traumatic or spontaneous splenic ruptures are rare but potentially fatal. Mortality is mainly due to delayed and therapeutic diagnosis as well as to the risks associated with a predisposed condition and with the severity of underlying pathologies. Splenectomy is necessary in the majority of cases. They can occur either in subject with macroscopically healthy spleen but, for instance, with infectious mononucleosis (IMN) or malaria or in subjects with pathologic spleen due to tumor, for example, but even in patients with some coagulopathies. We here report the case of a 6 year old child followed up for coagulopathy, admitted with diffuse violent abdominal pain, cutaneous-mucous paleness with hemodynamic stability. Laboratory tests showed macrocytic normochromic anemia; the diagnosis of splenic rupture was based on ultrasound and abdominal CT scan. Because the patient was hemodynamically stable, conservative treatment with 2 packed red blood cell transfusions was proposed. Patient's outcome was favorable.
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PMID:[Spontaneous rupture of the spleen in a child]. 3131 97

Primary splenic angiosarcoma (PSA) is a rare neoplasm of vascular origin associated with aggressive behavior and poor prognosis. The clinical presentation is usually non-specific and is mostly characterized by a wasting disease with anemia and splenomegaly, mimicking a wide range of entities. The authors present the case of an 80-year-old woman with cardiovascular comorbidities with a 6-month history of weight loss, fatigue, weakness, pallor, and abdominal pain. The physical examination showed massive splenomegaly and pallor. After a thorough evaluation that ruled out lymphoproliferative diseases, the working diagnosis was a myelodysplastic disorder. A few days after discharge, she returned to the emergency room with severe abdominal pain, worsening fatigue, and a remarkable pallor. Point-of-care ultrasound showed free intraperitoneal fluid. Spleen rupture was confirmed by abdominal computed tomography (CT) scan, and an emergency laparotomy with splenectomy was performed. The postoperative period was uneventful, and the patient recovered in a few days. The histopathology confirmed the diagnosis of PSA and the patient was referred to an oncological center. Two months later staging CT demonstrated liver and peritoneal metastases, and despite the chemotherapy she died 6 months after the diagnosis.
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PMID:Primary splenic angiosarcoma: a rare entity often associated with rupture and hemoperitoneum. 3137 60

A 3-year-old male child was presented with worsening abdominal pain, abdominal distension, lethargy, pallor and hepatosplenomegaly. The patient had multiple outpatient visits in the past and was treated with oral antibiotics, oral anthelmintic agents, albeit with minimal benefit. The patient also had non-neutropenic pyrexia spikes and oral ulcers. The patient was an adopted child; hence details about his biological parents' previous history were unclear. Differential diagnosis of Chronic Myelomonocytic Leukemia (CMML), Juvenile Myelomonocytic Leukemia (JMML), Gaucher's disease, Thalassemia and discrete pancreatic pathology was considered. Hemoglobin electrophoresis was indicative of thalassemia. Also, molecular detection method by polymerase chain reaction confirms a concurrent infection with Plasmodium knowlesi malaria. The BCR-ABL fusion gene was found to be negative. Correlating with peripheral monocytosis, bone marrow aspiration and trephine biopsy with blasts only 3-4% and hepatosplenomegaly, a diagnosis of JMML was established. We present a rare phenomenon with an overlap of signs and symptoms between JMML, underlying thalassemia, and Plasmodium knowlesi, posing a diagnostic challenge to physicians.
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PMID:Concurrent juvenile myelomonocytic leukemia with thalassemia in a case with Plasmodium knowlesi infection from Sabah, Malaysian Borneo. 3157 24


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