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

One hundred and eleven cases of syncope or loss of consciousness are analyzed. Most are of obscure nature while some illustrate features of syncope that deserve further scrutiny. The cases are divided into six groups: Resembling cardiac syncope (30 cases); vasovagal syncope (22 cases); features of both cardiac and vasovagal syncope (12 cases); orthostatic hypotensive (29 cases); akinetic seizure? (12 cases); and miscellaneous (5 cases). Some groups are subdivided according to the circumstances surrounding the spells, for example, seated eating, nocturnal, associated with bowel movement, response to anticonvulsant therapy, etc. The following conclusions seem warranted: The evidence favors the existence of a type of akinetic seizure resembling cardiac syncope; loss of consciousness while seated eating (prandial syncope) may comprise a syndrome; syncope related to bowel movement or abdominal pain is a striking association; sporadic nocturnal syncope due to temporary hyporeactivity of baroreceptors is not sufficiently recognized; alcohol ingestion may precipitate orthostatic hyporeactivity of baroreceptors is not sufficiently recognized; alcohol ingestion may precipitate orthostatic hypotension. Familial syncope, syncope proneness and cold drink syncope are illustrated.
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PMID:Syncope of obscure nature. 26 59

In the two years - 1st January, 1973 to 31st December, 1974 - 533 patients had operation for tubal pregnancy at the Gynaecology Unit of the Korle-Bu Teaching Hospital. About five cases per week were seen during this period. The incidence was 44 for every thousand deliveries at the Hospital. The case notes of 404 of the 533 patients have been reviewed. The age range was 15 to 44 years; 78% were in the 21 to 35 years age group. 81.4% had had pregnancies which went beyond 28 weeks. Only 13.7% had never had an intrauterine pregnancy. Tubal pregnancy is therefore not a disease of the primarily infertile as is commonly thought. There was no significant difference between the incidence on the right side and the incidence on the left side. The ampulla was the commonest site of implantation in the tube (45%). Tubal rupture (89.6%) was commoner than tubal abortion (10.4%). The principal signs and symptoms were abdominal pain, amenorrhoea, abdominal tenderness, abdominal distension, and signs of free fluid in the abdomen, syncope, anomalous vaginal bleeding, pallor and vomiting. The absence of amenorrhoea does not rule out the possibility of an ectopic. On pelvic examination the major signs were tenderness in a fornix and cervical excitation pain. Abdominal paracentesis and culdocentesis if positive are useful in diagnosis; negative results prove nothing. Laparascopy is of great value and should be employed in the difficult case. Beware of the patient in the reproductive age with anomalous vaginal bleeding, vague abdominal pains, syncopic attacks and anaemia. The mortality rate in the series was 0.7%.
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PMID:Tubal pregnancy: a review of 404 cases. 123 87

The authors prospectively examined the prevalence of somatization symptoms among community respondents after a natural disaster in Puerto Rico. Exposure to the disaster was related to a higher prevalence of medically unexplained physical symptoms, particularly gastrointestinal ones (abdominal pain, vomiting, nausea, excessive gas) and pseudoneurological ones (amnesia, paralysis, fainting, unusual spells/double vision).
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PMID:Somatic symptoms after a natural disaster: a prospective study. 160 80

We reviewed the clinical characteristics and outcome of cases of acute myocardial infarction occurring from January 1, 1985, through December 31, 1987, in the population of a long-term care institution for the elderly. The total number of patients in the series was 43. Comparisons were made between those patients transferred to a general acute-care hospital and those who remained at the facility. The most common initial symptoms of acute myocardial infarction in 32 of 48 patients were, in order, dyspnea, dizziness or syncope, precordial pain, and abdominal pain. Nine (of 43) patients were asymptomatic. In the 14 (of 43) patients transferred to an acute-care hospital, cardiac failure, arrhythmias, and cardiogenic shock were much more frequent than among those retained in the long-term care facility. We concluded that a high index of suspicion for the diagnosis of acute myocardial infarction in the institutionalized elderly is indicated. Patients with mild infarction can be retained in long-term care institutions; resulting mortality from cardiac disorders should be low in adequately staffed and equipped long-term care institutions.
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PMID:Acute myocardial infarction in a long-term care institution for the aged. 173 40

A 34-year-old woman, gravida 6 with 10 weeks of gestation was admitted because of abdominal pain and fainting. On physical examination she had hypotension, was pale with abdominal tenderness and guarding. Culdocentesis yielded unclotted blood. Immediate laparotomy was performed, because a diagnosis of ectopic pregnancy was made. About 2,500 ml of fresh blood was found in the abdominal cavity. Appendicular artery tear caused active arterial bleeding. The torn appendicular artery was observed to be the consequence of perforated appendicitis, which, in turn, was caused by a faecalith. Appendectomy was performed and she made a good recovery.
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PMID:Intra-abdominal bleeding in appendicitis. 179 88

Recombinant interferon alfa (rIFN-alpha) was given to 31 children with acute lymphoblastic leukemia (ALL) in first on-therapy marrow relapse as the sole treatment (30 megaunits/m2/d intravenously x 10 days) before standard four-drug reinduction and during multiagent continuation therapy (30 megaunits/m2 subcutaneously x 3 consecutive days every 3 weeks). After 10 days of rIFN-alpha, there were two partial remissions (PRs); seven additional patients had either greater than or equal to 25% reduction in the percentage of marrow blast cells or hypoplastic marrow. Two patients had progressive disease with an increase in leukocyte counts. All patients experienced influenza-like symptoms, and there were isolated instances of severe abdominal pain and personality change. Dose-limiting toxicity comprised grade III/IV transaminase elevation (two patients) and syncope with personality change (one patient). Twenty-three of 31 children (74%) subsequently achieved marrow remission using standard agents. One patient was taken off study during teniposide (VM-26) and cytarabine (ara-C) consolidation due to toxicity. Continuation therapy including rIFN-alpha pulse was well tolerated in the remaining children; only one patient required rIFN-alpha dosage reduction (for CNS toxicity). rIFN-alpha toxicity did not necessitate reductions in doses of standard chemotherapy agents or significant delays in therapy. Five patients remain in remission at 26+ to 36+ months; 13 patients relapsed in marrow, one in the meninges (7 months), and one in meninges, mediastinum, and lymph nodes (2 months). Two children were removed from study for marrow transplant. In summary, high-dose rIFN-alpha alone had a modest antileukemic effect. In contrast to the clinical experience with combined rIFN-alpha and chemotherapy in adults, rIFN-alpha given in a pulse-like manner throughout continuation therapy did not compromise the intensity of the standard chemotherapy regimen.
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PMID:Recombinant interferon alfa given before and in combination with standard chemotherapy in children with acute lymphoblastic leukemia in first marrow relapse: a Pediatric Oncology Group pilot study. 201 19

Risk factors for ectopic pregnancy include previous ectopic pregnancy, current intrauterine device use, prior fallopian tube surgery, previous pelvic inflammatory disease and a prior history of infertility. Abdominal pain is the most common symptom, followed by amenorrhea or vaginal bleeding, nausea, vomiting, syncope and dizziness. Referred shoulder pain following the onset of abdominal pain is characteristic of intraperitoneal bleeding and, in the appropriate clinical setting, strongly suggests a ruptured ectopic pregnancy. A coordinated evaluation includes measurement of serum human chorionic gonadotropin concentration and transabdominal or, preferably, transvaginal ultrasonography. Treatment is primarily by one of a variety of surgical techniques. Medical therapy with methotrexate or other drugs is currently under investigation.
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PMID:Management of ectopic pregnancy. 218 38

We reviewed written and audio records of paramedic-base hospital radio contact to determine whether care differed from that suggested in standard prehospital care protocols. Records of all 659 contacts for seizure, syncope, abdominal pain, or altered mental state during 1987 (28.4% of all contacts) were scored for the use of standard therapies (such as intravenous access, oxygen, naloxone hydrochloride) and unanticipated therapies (intubation, nitroglycerin). Cases that involved unanticipated treatments were reviewed to determine whether they could have been prospectively identified by simple clinical findings. Standard therapies were used in the majority of patients. Unanticipated therapies were administered to 13 patients, all of whom had abnormal vital signs, diaphoresis, respiratory distress, or a second prominent symptom. Data suggest that protocols could replace radio contact for most patients and that the few who might benefit from radio contact can be easily identified. A 90% reduction in radio contacts in Los Angeles county could save $3 million each year.
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PMID:Does paramedic-base hospital contact result in beneficial deviations from standard prehospital protocols? 205 61

A 37-year-old, gravida 5 with 41 weeks of gestation was admitted because of slight vaginal bleeding, abdominal pain, and absence of fetal movements for a few days. Previously she had been admitted to a provincial hospital with sudden severe abdominal pain and fainting at the second month of her pregnancy and ectopic pregnancy was suspected. She was discharged the following morning, after all signs and symptoms had completely disappeared without any special investigation. On her last admission all clinical examinations were normal but fetal heart sound was absent. The cervix was closed and uneffaced. Abdominal X-ray showed signs of fetal death. Sonography confirmed a dead fetus in utero but with placenta previa totalis. A laparotomy was performed. A macerated female fetus, weighting 3,800 g was found in the amniotic sac lying in the abdominal cavity. The placenta was attached to the dorsal surface of her abdomen close to the large intestine and the omentum; the entire placenta was untouched and left in the peritoneal cavity. There were no postoperative complications. She recovered well and was discharged after 7 days.
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PMID:Advanced abdominal pregnancy: a case report. 235 5

We compared the clinical and biochemical profiles of 11 patients with idiopathic flushing (IF) with those of eight patients with carcinoid syndrome (CS). Patients with IF were more often women, had a longer duration of symptoms, and were younger. Palpitations, syncope, and hypotension occurred only in patients with IF, while wheezing and abdominal pain occurred only with CS; diarrhea occurred in both types of patients. Elevated blood serotonin levels were present primarily in CS. Increased levels of urine 5-hydroxyindoleacetic acid was specific for CS but unsufficiently sensitive to detect all cases. Abnormalities of gut and vasoactive peptides failed to distinguish the two conditions. Flushing in carcinoid patients responds uniformly to octreotide (Sandostatin), but only one third of the patients with IF are relieved of the symptom. Patients with IF have features that distinguish them from individuals with flushing from other causes, such as CS, postmenopausal state, chlorpropamide-alcohol flush, panic attacks, medullary thyroid carcinoma, and autonomic epilepsy. Familiarity with the clinical and biochemical features of IF should facilitate evaluation and identification of these patients.
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PMID:Distinguishing features of idiopathic flushing and carcinoid syndrome. 246 88


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