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

We presented three sheets of growth chart in children with chronic fatigue syndrome. The growth chart in 14-year-old boy (patient 1) showed decreased weight gain because of too much exercise. After that he complained nausea, abdominal pain, sleep disturbance and debilitating fatigue. The growth chart in 12-year-old girl (patient 2) revealed increased weight gain because of overeating due to the divorce of her parents. She developed syncope, sleep disturbance, and fatigue during overeating. The growth chart in 13-year-old girl (patient 3) showed decreased weight gain after she developed lymph node enlargement. We diagnosed her as autoimmune fatigue syndrome because of persistent positive antinuclear antibody. Although growth chart will not be able to detect childhood chronic fatigue syndrome prospectively, the chart may be useful for detecting some life events in these children.
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PMID:[Usefulness of growth chart in children and adolescents with chronic fatigue syndrome]. 1756 6

Subtle or discrete (class 3 in the classification of the European Society of Cardiology) dissection is the most neglected variant of aortic dissection. This study was conducted to define the clinical manifestations, diagnostic findings, and outcomes of subtle or discrete dissection involving the ascending aorta. The clinical and surgical records, preoperative studies, and outcomes of 109 consecutive patients with ascending aortic dissection observed from 1995 to 2005 were reviewed. Eight patients (7.3%) had discrete dissection. Five patients presented with acute anterior chest pain, 2 with abdominal pain, and 4 with syncope. The mean diameter of the ascending aorta was 44 +/- 8.8 mm. The intimal tears were located in all patients on the posterior aspect of the ascending aorta 1 to 40 mm above the left coronary ostium; its length varied from 2.8 to 12.3 mm. Preoperative aortography, magnetic resonance imaging, and computed tomography could not identify the discrete intimal tears. Transesophageal echocardiography provided unique diagnostic information on (1) subtle intimal discontinuity, (2) circumscribed intramural hematoma, and (3) discrete pericardial fluid around the dissected aorta. Six patients underwent emergency surgery on the basis of echocardiographic findings, and they were all alive at follow-up. Compared with patients with classic aortic dissection, those with discrete dissection had lower operative mortality (0% vs 26%, p = 0.11), shorter hospital stay (7.2 +/- 2.8 vs 21 +/- 19 days, p = 0.01), and less frequent need for blood transfusions (0% vs 39%, p = 0.02). In conclusion, elevated clinical suspicion and detailed transesophageal echocardiographic examination are important for the early identification of discrete aortic dissection, leading to prompt surgery, shorter hospital stays, and better outcomes.
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PMID:Clinical and anatomical characteristics of subtle-discrete dissection of the ascending aorta. 1792 Mar 78

A 32-year-old woman was diagnosed with leucopenia in 2002, being antinuclear antibody, anti-DNA antibody, and antiphospholipid antibody positive, and she was administered low-dose aspirin. In July 2006, she was admitted to our hospital because of pyrexia and abdominal pain. Examination revealed paralytic ileus, absence of the pupillary light reflex, dyshidrosis and anuresis. In addition, with high-level interleukin-6 in cerebrospinal fluid, the sensory nerve conduction velocity was derivation impotence. She was subsequently diagnosed with systemic lupus erythematosus (SLE) with central nervous system involvement, peripheral neuropathy as well as acute pan-dysautonomia. After pulse corticosteroid therapy, paralytic ileus was improved, however, the urination disorder persisted, and syncope due to orthostatic hypotension became marked. Plasma exchange and a second course of pulse corticosteroid therapy were performed, and were ineffective, whereas intravenous cyclophosphamide was effective. This patient is a rare case of central nervous system, peripheral neuropathy as well as acute pan-dysautonomia with SLE.
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PMID:Acute pan-dysautonomia as well as central nervous system involvement and peripheral neuropathies in a patient with systemic lupus erythematosus. 1855 52

Prior studies have found that > 50% of prehospital intravenous catheters (i.v.s) were unutilized for treatment; however, few data are available regarding which patients benefit. The objective of this study was to examine the association between i.v. utilization in the field, paramedic primary impression, and patient presentation. Prehospital records for 34,585 patients were evaluated for i.v. placement and utilization in the field. Logistic regression was used to evaluate the association of primary impression, systolic blood pressure, heart rate, respiratory rate, Glasgow Coma Scale score, skin sign color, and capillary refill with placement and utilization. Intravenous catheters were placed in 60% of patients, but only 17% of the total was utilized. Examples of primary impressions with frequent initiation and low utilization (n = number in group, % of total with i.v. placed, % of total used): post-seizure (n = 989, 72%, 9%); weakness/dizzy/nausea (n = 3092, 69%, 20%), syncope/near-syncope (n = 2034, 81%, 26%), and abdominal pain (n = 1554, 70%, 14%). Fifty-eight percent with normal vital signs received an i.v. and 28-30% were utilized; hypotension: 80% received i.v. (odds ratio [OR] 1.211, p = 0.012), 70% utilized; hypertension: 61% received i.v. (OR 1.060, p = 0.027), 28% utilized; bradycardia: 82% received i.v. (OR 1.588, p < 0.0001), 51% utilized; tachycardia: 66% received i.v. (OR 1.152, p = 0.001), 33% utilized; bradypnea: 93% received i.v. (OR 1.638, p = 0.051), 86% utilized; tachypnea: 70% (OR 1.120, p = 0.024), 33% utilized. A Glasgow Coma Scale score < 15: 76% received i.v. (OR 1.672, p < 0.0001), 32% utilized. Abnormal skin color: 79% received i.v. (OR 1.691, p < 0.0001), 42% utilized. Certain primary impressions are associated with high i.v. initiation rates but infrequent utilization. High utilization rates were associated with hypotension, bradycardia, bradypnea, and abnormal skin signs. Study of high-frequency, low-utilization groups could reduce unnecessary i.v. placement.
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PMID:When are prehospital intravenous catheters used for treatment? 1857 88

Twenty-one years old primigravida presented to emergency with amenorrhoea for 2 months and complaints of severe abdominal pain for few hours. The pain was associated with 2 episodes of fainting attacks in emergency during the period of observation. Viable intrauterine pregnancy of 8-9 weeks along with collection of fluid in the Pouch of Douglas was detected by ultrasound examination and on laparotomy ectopic pregnancy was confirmed with haemoperitoneum of 2 litres with 500gms of clots. Histopathology report confirmed the tubal ectopic pregnancy and postlaparotomy, transvaginal sonography confirmed the salvage of the intrauterine pregnancy. Despite massive haemoperitoneum, the pregnancy continued till 40+6 weeks with uneventful antenatal period. She underwent emergency caesarean section for meconium stained liquor with foetal distress and delivered of an alive healthy female of 2.5 kg with good Apgar score.
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PMID:Heterotopic pregnancy with spontaneous intrauterine conception: a rare clinical entity with diagnostic dilemma. 1860 25

The development of small-diameter active fixation pacing and implantable cardioverter-defibrillator leads may be associated with increased risk for delayed right ventricular perforation. The management of this unforeseen complication has been poorly described. Eleven successive patients referred for right ventricular subacute or delayed perforation (no evidence of lead perforation at the time of the procedure, perforation of the right ventricle diagnosed > or =5 days after implantation) were reviewed. The perforation was related to a pacing (n = 7) or an implantable cardioverter-defibrillator (n = 4) lead. The main symptoms were major dyspnea with pericardial effusion requiring emergency pericardial drainage (n = 3), inappropriate implantable cardioverter-defibrillator shock (n = 1), syncope (n = 2), abdominal pain (n = 1), mammary hematoma (n = 1), diaphragm stimulation (n = 1), and chest pain (n = 1). One patient was strictly asymptomatic. Signs of lead dysfunction were observed in all 11 patients. The diagnosis of lead perforation was confirmed by chest x-ray, echocardiography, or computed tomography. Surgery was directly performed in 1 patient with suspicion of digestive perforation. In the remaining 10 patients, the leads were removed by simple traction under fluoroscopic guidance in the operating room, with surgical backup support. The need for close monitoring was highlighted by the occurrence in 1 patient of tamponade requiring percutaneous pericardiocentesis and urgent surgical revision. The postoperative course of these patients was unremarkable. In conclusion, subacute ventricular perforation is a rare but potentially life threatening complication of lead implantation. In most patients, the leads can safely be removed under fluoroscopic guidance, with surgical backup support and close monitoring.
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PMID:Management of subacute and delayed right ventricular perforation with a pacing or an implantable cardioverter-defibrillator lead. 1899 54

Gastrointestinal bleeding may present with haematemesis, fresh rectal bleeding, melaena, abdominal pain, syncope and shock. Most patients require observation and no treatment. The majority of those requiring treatment stop bleeding spontaneously and the management is supportive. More aggressive investigation and treatment are required for persistent massive bleeding. Large bleeds require rapid volume replacement using saline or plasma, with blood transfusion as urgently as possible.
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PMID:[Approach in First Aid to children with gastrointestinal hemorrhage]. 1943 51

Spontaneous renal artery aneurysm (RAA) rupture is a rare, but potentially fatal, cause of abdominal pain. A case is reported of a ruptured RAA in a previously well 45-year-old woman who presented with abdominal pain and syncope. Bedside ultrasound was unremarkable; however, a prompt abdominal computed tomography scan secured the diagnosis. Endovascular stenting was performed and the patient recovered.
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PMID:Spontaneous renal artery aneurysm rupture: an unusual cause of abdominal pain and syncope. 1962 71

The small intestine is the most common site of gastro-intestinal metastasis from cutaneous malignant melanoma. A primary origin at this site has been reported in rare cases. We report a case of a 71-year-old man with a primary malignant melanoma in the jejunum. The patient presented with weakness, weight loss, non-specific abdominal pain and episodes of fainting. After clinical examination, laboratory evaluation and radiological work-up, which included CT of the abdomen, the patient was diagnosed with a tumour mass in the jejunum. This diagnosis was confirmed at laparotomy. The patient underwent enterectomy with wide excision of the tumour. A primary malignant melanoma of the small intestine is an extremely rare neoplasm. A definite diagnosis can only be made after a thorough investigation has been made to exclude the co-existence of a primary lesion elsewhere. Curative resection of the tumour remains the treatment of choice.
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PMID:Primary malignant melanoma of the small intestine: a case report. 1994 2

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


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