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

Bilateral putaminal necrosis is characteristic of methanol poisoning. A 31-year-old male alcoholic had headache, impaired consciousness, neck stiffness, roving eyes with dilated unreactive pupils, papilloedema, abdominal pain, vomiting, and severe metabolic acidosis after a binge. Abnormalities of the cerebrospinal fluid included an initial pressure of 240 mmH2 O, RBC 286/mm3, WBC 8/mm3, and protein 179 mg/dl. Peritoneal dialysis was performed on the 2nd day after drinking. A blood test for methanol was not performed until the 5th day, and its results was negative. However, computed tomography (CT) on the 3rd day showed necrosis and hemorrhage of bilateral putamina and the cerebral cortex, and post-contrast enhancement of meninges. On the 22nd day, a CT revealed further changes: necrosis of bilateral subcortical white matter, and post-contrast gyral enhancement at the otherwise normal-looking areas of the cerebral cortex. We suggest that, in certain situations, the characteristic CT findings are helpful in the diagnosis of methanol poisoning.
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PMID:Bilateral putaminal necrosis caused by methanol poisoning: a case report. 131 54

An intra-abdominal cyst is a rare complication of ventriculoperitoneal (VP) shunt. A 19-year-old male was admitted complaining of abdominal pain and distension, dysuria, constipation, headache, and fever. He had undergone a VP shunt for obstructive hydrocephalus caused by a cerebellar astrocytoma 16 years earlier, and had received shunt revision twice, 5 years and 3 months earlier, respectively. Examination on admission revealed neck stiffness, early papilledema, a mass in the lower abdomen, and abdominal muscular guarding with rebound tenderness. Laboratory studies showed leukocytosis of the peripheral blood and pleocytosis of the cerebrospinal fluid (CSF). Abdominal ultrasonograms and computed tomographic scans demonstrated a cystic lesion. Under the diagnosis of meningitis and local peritonitis with an intra-abdominal cyst, we sistemically administered antibiotics and externalized the shunt. However, since the cyst fluid could not be aspirated through the abdominal catheter, it was exchanged with a flexible catheter under fluoroscopic control, according to Seldinger's method. A total of 400 ml of cyst fluid was drained. Staphylococcus epidermidis was detected in both the cyst fluid and the CSF. After meningitis subsided, repositioning of the abdominal catheter into the other side of the abdomen was performed but resulted in shunt malfunction and meningitis due to the same organisms. After meningitis again subsided, the VP shunt was converted to a ventriculoatrial shunt. The clinical course was uneventful thereafter.
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PMID:Intra-abdominal cyst following revision of ventriculoperitoneal shunt--case report. 170 49

During 1988, an endemic outbreak of aseptic meningitis was noted in the Kaohsiung area. Throughout the year, a total of 89 cases were identified by cerebrospinal fluid (CSF) examination at the Pediatric Department of Kaohsiung Medical College. The peak incidence was from June to October. Scattered cases still occurred during November and December. The male to female ratio was 1.7:1 and the age distribution ranged from 1 month to 15 years old. Two peaks of age distribution were observed; one in infancy and the other in the 4-7 year old age group. Most of them exhibited fever (94.4%), headache (68.9%), and vomiting (68.5%). Other associated symptoms and signs included neck stiffness, sore throat, cough, Brudzinski's sign, abdominal pain, seizure, dizziness, rhinorrhea, diarrhea, Kernig's sign, skin rash, hyperemic conjunctiva, apnea, and oral ulcers. Most of them had CSF white blood cell (WBC) counts less than 1000/mm3, normal or mild elevated protein, and normal CSF/plasma sugar ratio. Three patients were found to have a virus in their CSF without pleocytosis. Virus isolations from CSF throat swabs and/or rectal swabs were performed in 65 patients, half of them (35/65, 53.8%) had positive results including echovirus type 9 (sixteen), echovirus type 30 (eighteen), and adenovirus type 3 (one). Echovirus type 9 was predominant during July and August whereas echovirus type 30 became predominant after September. All patients recovered spontaneously without any sequelae.
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PMID:Clinical observations and virological study of aseptic meningitis in the Kaohsiung area. 198 74

Strongyloidiasis is a human intestinal parasitosis caused by the nematode Strongyloides stercoralis. In most cases the infection is subclinical, but rarely, disseminated strongyloidiasis may occur in debilitated or immunocompromised patients, and in those who receive immunosuppressive agents. In this report, we describe an unusual case of severe disseminated strongyloidiasis, with intestinal, pulmonary and neurological manifestations, in a previously healthy male. The onset of the disease was acute with headache and neck stiffness, due to subarachnoid-ventricular haemorrhage. During a protracted clinical course the patient developed diarrhoea, abdominal pain, recurrent paralytic ileus, pneumonitis and respiratory distress, malabsorption and weight loss, diagnosis was delayed due to the complicated course and rarity of the disease. The diagnosis finally established during evaluation for malabsorption by demonstrating larvae of S. stercoralis in the jejunal mucosal biopsy and faeces. Response to mebendazole treatment was prompt with complete recovery and resolution of all systemic manifestations. Early diagnosis and treatment of strongyloidiasis in the intestinal phase is critical in the prevention of dissemination, which may prove lethal due to life-threatening complications.
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PMID:Disseminated strongyloidiasis with uncommon manifestations in Greece. 378 11

Three young adult drug users obtained wild lettuce and valerian root, prepared a crude aqueous extract of the wild lettuce, and injected the extract i.v. One also injected an alcohol extract of the valerian root. All 3 rapidly became ill with fevers, chills, abdominal pain, flank and back pain, neck stiffness, headache, leucocytosis and mild liver function abnormalities, but recovered over the next 3 d. Various literature and internet sources claim that wild lettuce has opiate properties not demonstrated in this case.
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PMID:The case of the salad shooters: intravenous injection of wild lettuce extract. 977 67

Human parvovirus B19 infection can cause erythema infectiosum (EI) and several other clinical presentations. Central nervous system (CNS) involvement is rare, and only a few reports of encephalitis and aseptic meningitis have been published. Here, we describe 2 cases of B19 infection in a family presenting different clinical features. A 30 year old female with a 7-day history of headache, malaise, myalgias, joint pains, and rash was seen. Physical examination revealed a maculopapular rash on the patient's body, and arthritis of the hands. She completely recovered in 1 week. Two days before, her 6 year old son had been admitted to a clinic with a 1-day history of fever, headache, abdominal pain and vomiting. On admission, he was alert, and physical examination revealed neck stiffness, Kerning and Brudzinski signs, and a petechial rash on his trunk and extremities. Cerebrospinal fluid analysis was normal. He completely recovered in 5 days. Acute and convalescent sera of both patients were positive for specific IgM antibody to B19. Human parvovirus B19 should be considered in the differential diagnosis of aseptic meningitis, particularly during outbreaks of erythema infectiosum. The disease may mimic meningococcemia and bacterial meningitis.
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PMID:Two family members with a syndrome of headache and rash caused by human parvovirus B19. 1129 Mar 13

Reovirus Type 2 was isolated from three patients aged 5, 9 and 10 years. The etiological role of Reovirus in one case was confirmed by demonstration of antibodies in convalescent serum and none in acute serum. Symptoms in this case were suggestive of infectious mononucleosis. In the second case, rhinitis and non-purulent otitis were preceded by two waves of fever, abdominal pain and emesis. Acute serum was not available but convalescent serum had a high titre to a Reovirus, thus supporting a Reovirus etiology. Symptoms in the third case were fever, intermittent headache, neck stiffness, abdominal cramps and weakness of a leg. Because of the unavailability of convalescent serum, evidence of a Reovirus etiology was incomplete. No attempt is made to associate Reovirus with a particular clinical picture. Rather, attention is simply drawn to the existence of Reovirus infections in Ontario.
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PMID:Occurrence of reovirus infection in Ontario. 1400 9

We report the case of a 28-year-old woman who presented simultaneously with superior sagittal sinus thrombosis and thyroid crisis, and was subsequently found to have protein C deficiency. February 3, 2003, she admitted complaining of abdominal pain. The diagnosis of appendicitis was made, and she was operated on under lumbar anaesthesia. Day 7, she developed acute headache and distal weakness of the left lower limb. On examination she was alert, with a temperature of 38 degrees C, a sinus tachycardia of 124/min and blood pressure 164/84 mmHg. Neurological examination revealed neck stiffness and left hemiparesis, predominantly in her lower limb. Gadlinium-enhanced brain MRI revealed extensive superior sagittal sinus thrombosis. CT scan demonstrated infarction in the right frontal cortex, and subarachnoid hemorrhage adjacent to the right cerebellar tentorium. The patient was treated with a free radical scavenger edarabon, and glycerin. No anticoagulant therapy was instituted. Over the next 24 hours, her condition worsened. She became comatose, as well as developing a generalized tonic-clonic seizure. Day 12, laboratory examinations revealed an undetectable TSH-level CTSH (thyroid stimulating hormone) <0.005 mcIU/ml), with a level of free thyroxin 7.77 ng/dl (0.9-1.7), free triiodothyronin 29.6 pg/ml (2.3-4.3), and positive anti-TSH receptor antibodies determined subsequently. Coagulation factor VIII activity was 155% (normal range 60-150). Protein C deficiency (antigen 59%, activity 49%) was also present, suggesting a congenital type I heterozygous deficiency. A diagnosis of thyroid crisis on the basis of Graves' disease was made. The patient remained comatose and died on Day 16, with renal failure. The patient had protein C deficiency, a well-established risk factor for cerebral venous thrombosis (CVT). However, additional risk factors are required in most cases to precipitate CVT. In our case, this trigger was most likely thyroid crisis, suggesting that thyrotoxicosis, probably through hypercoagulability, may be a predisposing factor for the development of CVT.
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PMID:[Thyroid crisis and protein C deficiency in a case of superior sagittal sinus thrombosis]. 1737 Jun 53

Battered child syndrome can refer to children exposed to harmful, non-accidental and preventable physical treatment by those are responsible for their care which prevents the child's physical, cognitive and spiritual development. A 28 months old boy was submitted to hospital due to abdominal blunt trauma. He had been firstly applied to Isparta Children Hospital by his parents with the complaint of fever. In the first examination, he was conscious, his general condition was poor there was respiratory acidosis, and neck stiffness was present. There were several fresh traumatic lesions on his face and left arm. His complaints were thought due to meningitis and antibiotics were started. He was transported to Suleyman Demirel University Hospital after a day because of vomiting, abdominal pain, tender, distended and silent abdomen, and air-fluid levels in direct abdominal X-rays. An old fracture of the right 9th rib was detected with chest X-ray in university hospital. Additionally, abdominal ultrasound scan showed distended bowel loops filled with fluid. Laparotomy revealed a complete rupture of the junction of the third and fourth parts of the duodenum and several hemorrhagic regions on bowel loops. The patient was discharged after 42 days. This case report described the case through both medical and legal processed in Turkey.
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PMID:A battered child case with duodenal perforation. 1842 61

A 47-year-old man presented with abdominal pain, neck stiffness, severe transient hypertension and unusually dark urine. Cerebrospinal fluid investigations and angiography confirmed the diagnosis of a subarachnoid haemorrhage. Porphyrin studies on the patient and his family demonstrated that the family has acute intermittent porphyria. This is the second case report of an acute hepatic porphyria presenting with a subarachnoid haemorrhage. Acute transient hypertension during the attack of porphyria caused the rupture of an intracranial arterial aneurysm.
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PMID:Acute intermittent porphyria presenting with a subarachnoid haemorrhage. 1956 64


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