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

Two patients with epithelioid haemangioendotheliomata of the liver are described. Both presented with abdominal pain and malaise, with hepatomegaly and a variable degree of hepatocellular dysfunction. Diagnosis was delayed in both cases, each patient undergoing a protracted series of investigations including repeated liver biopsies. The major obstacles to early diagnosis were a lack of clinical awareness of the condition and difficulties in interpretation of the liver histology: the widespread sclerosis in the tumour tissue is easily mistaken for a post-necrotic or cirrhotic process. The key to the diagnosis is the demonstration of cells containing Factor-VIII-related antigen confirming the endothelial origin of the tumour. One patient died within three months of presentation and the other after 18 months. The tumour may, therefore, be more aggressive than earlier reports seem to suggest. It seems likely that the tumour is being under-diagnosed and although no specific therapy has been shown to be of value, a greater awareness of the condition, resulting in a more prompt diagnosis, should save patients from undergoing unnecessary investigation.
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PMID:Hepatic epithelioid haemangioendothelioma: difficult name, difficult diagnosis? 317 23

In an attempt to define a clinical index for the timing of blood cultures in febrile patients with acute leukemia, subjective symptoms at onset of bacteremia were investigated in a total of 109 consecutive episodes. General malaise, chills, and nausea and vomiting were most frequently observed (66%, 59%, and 50%, respectively). The gastrointestinal (GI) symptoms including nausea and vomiting, abdominal discomfort and fullness, abdominal pain, and diarrhea were encountered in 72% of all the episodes, forming the second largest group next to those closely associated with high fever. These GI symptoms were usually mild and of brief durations, and their occurrence had no relation to sites of infections or etiology of bacteremia. In some cases, nausea and vomiting were aggravated by intensive antileukemic chemotherapy or massive GI bleeding. It was thus suggested that GI symptoms, particularly nausea and vomiting, concomitant with a remarkable, sometimes abrupt rise in temperature during granulocytopenia may serve as a useful index for the timing for blood collection for culture to improve the probability of detection of bacteremia.
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PMID:A clinical index for the timing of blood cultures in febrile patients with acute leukemia. 320 53

An infected urachal cyst classically presents with a tender lower midline abdominal mass and systemic signs of infection, including fever, malaise, and leukocytosis. At times, the findings may be clinically confused with those of acute appendicitis, Meckel's diverticulitis, or peritonitis. Sonography aids in differentiating these entities by identifying the localized cystic mass containing debris, located anteriorly in the low mid-abdomen, extending from the region of the bladder to the umbilicus. We present an unusual case of an infected urachal cyst in a 6-year-old boy who presented with lower abdominal pain, fever, intermittent diarrhea, polyuria and dysuria, a firm, fixed left lower quadrant tender mass, and an elevated white blood cell count.
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PMID:An unusual presentation of an infected urachal cyst. Review of urachal anomalies. 327 61

Forty-five of 47 patients with distal ulcerative colitis completed a two-week double-blind, randomized, controlled trial to determine if 4-aminosalicylic acid (4-ASA) enemas, 1 g bid or 2 g bid, were therapeutically effective compared to placebo. Forty-one patients enrolled because they were refractory to or had side effects during conventional therapy with sulfasalazine or corticosteroids. Proctoscopic examination was done before and after two weeks of treatment. Patients kept daily diaries assessing: blood in stools, mucus in stools, tenesmus, abdominal pain, loss of appetite, fatigue, weight loss, and malaise. Severity of each symptom ranged from 0 (absent) to 3 (severe). A total severity score was calculated from the above for each patient. At the end of the two-week study, 35 patients elected to take 4-ASA in an open-label trial for one year. 4-ASA enemas in the 1-g bid but not the 2-g bid dosage were significantly more effective in improving symptoms than placebo: P less than or equal to 0.05. Neither dose of 4-ASA enema was better than placebo in improving the sigmoidoscopic appearance at the end of two-weeks. Forty-six percent of patients had complete resolution of all signs and symptoms in the open-label trial and 31% were better but still had sigmoidoscopic evidence of disease, a total response rate of 77%. Side effects were similar in the placebo and 4-ASA groups. We conclude that 4-ASA enemas in a dose of 1 g bid are safe and effective in the treatment of distal ulcerative colitis.
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PMID:4-Aminosalicylic acid retention enemas in treatment of distal colitis. 329 74

Viral oncolysates (VO) derived from two cultured ovarian carcinoma cell lines infected with influenza A/PR8/34 were administered intraperitoneally (IP) to 40 patients with advanced ovarian carcinoma, including 31 with late-onset ascites and 5 with pleural effusions. PR8 virus-specific antigens and ovarian tumor-associated antigens have been demonstrated on two oncolysates designated OVO1 and OVO2. Thirty-five patients received 9 mg of a 1:1 mixture of OVO1 and OVO2, 5 patients received one or the other. During the first month three IP schedules were evaluated, i.e., single, biweekly, and weekly, which were followed by monthly injections. Intrapleural (IP1) injections of a 3.0-mg 1:1 mixture of OV1 and OV2 were administered to 3 patients concurrently with initial IP injections and to 2 patients following later development of pleural effusions. In 7 patients ascites disappeared; in 5 of these the number of cytologically detected malignant cells was markedly reduced, in 1 pleural effusion disappeared, and in 3 tumor masses were reduced. Tumor masses shrank also in 2 patients without ascites. Tumor reduction conformed to standard response criteria in 2 of the 5 patients. Response duration in the 9 responding patients lasted from 3 to 19 months and survival durations 4 to 42 months. Disease symptoms in 7 patients improved noticeably. Two of the 9 responders later developed unilateral pleural effusions that responded for 7 and 15+ months to a single IP1 injection. Seventeen patients experienced one or more treatment side effects including fever, nausea or anorexia, malaise, abdominal pain, and arthralgia, but in only 2 patients, both on the weekly schedule, was toxicity severe enough to require treatment withdrawal. Humoral responses to viral and tumor cell-surface antigens were frequently observed in patients demonstrating clinical activity.
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PMID:Viral oncolysates in patients with advanced ovarian cancer. 334 54

The development of bilateral parapelvic hemorrhagic pseudocysts with abdominal pain, systemic symptoms of malaise and fever, elevation of erythrocyte sedimentation rate and serum alkaline phosphatase, and decreased renal function is described in a patient taking anticoagulants. The symptoms and signs resolved with the resolution of the hemorrhagic pseudocysts. The bilaterality and selective localization of these hemorrhages suggest the existence of a specific pathogenesis. The advent of new imaging techniques in the last decade allows for a diagnosis and a better understanding of the pathologic processes that affect the renal sinus.
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PMID:Bilateral hemorrhagic parapelvic pseudocysts. 335 71

A woman 68 years of age had fever, malaise, diffuse lymphadenopathy, splenomegaly followed by abdominal pain, and diarrhea. A lymph node biopsy specimen showed nonspecific follicular hyperplasia. Symptoms were responsive initially to prednisone. Recurrent symptoms warranted colonic biopsy, which was consistent with Crohn's disease, and were responsive partially to prednisone and azulfidine. Because of progressive deterioration, a repeat lymph node biopsy was performed and showed the characteristic histologic feature of angioimmunoblastic lymphadenopathy (AILD). The evolution of the histopathologic features of the case is discussed, and gastrointestinal (GI) manifestations of AILD are reviewed. Although the GI tract is an unusual site for extra nodal AILD, colonic involvement can imitate the clinical and histologic features of inflammatory bowel disease.
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PMID:Colonic involvement in angioimmunoblastic lymphadenopathy resembling inflammatory bowel disease. 336 52

Twenty-four cases of pyogenic liver abscess admitted between 1977 and 1986 are presented. A mean age of 43 years (range 5-78) with a 3:1 male:female ratio and 25% mortality were noted. Fever and abdominal pain were encountered in over 80% of cases and anorexia and malaise in over 60%. Hepatomegaly and right upper quadrant tenderness were the commonest signs. Leucocytosis, raised alkaline phosphatase and gamma-glutamyl transpeptidase, and hypoalbuminaemia were each noted in roughly 80% of cases. None of these showed any prognostic significance. Predisposing factors were noted in 11 cases. No cases of associated biliary disease were noted. Multiple, polymicrobial, aerobic and mixed aerobic/anaerobic abscesses were associated with a higher mortality. Patients aged over 50 years or more also had a higher mortality (P less than 0.05). Anaerobic abscesses were often solitary and were associated with a lower mortality (P less than 0.05). Surgical drainage and guided percutaneous drainage showed no difference in morbidity.
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PMID:Clinical aspects of pyogenic liver abscess: the University Hospital of the West Indies experience. 337 58

We have reported a case of diarrhea caused by Blastocystis hominis, an intestinal protozoan parasite of man. The organism is present in small numbers in up to one fifth of stool samples in hospitalized patients, but is associated with diarrhea in only heavily infested patients. Typical symptoms include diarrhea, crampy abdominal pain, nausea, vomiting, low-grade fever, gas, malaise, and chills. Fecal leukocytes are occasionally seen. The pathophysiologic mechanism of the diarrhea is not clear. Not all patients having large parasite burdens are symptomatic. Metronidazole, 1 to 2 gm/day orally in divided doses, is the treatment of choice.
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PMID:Diarrhea due to Blastocystis hominis: an old organism revisited. 360 19

Abdominal tuberculosis, although rare, occurs mainly in immigrants from the Indian subcontinent. Such people comprise 13.5% of our local population and contributed 90% of a series of 72 patients presenting in the last 16 years; a local disease incidence of 1:6000 for Asian immigrants. Men and women were equally affected, but on average women were much younger. Diagnosis was made from one month to 10 years after immigration. No clinical feature was diagnostic, but abdominal pain, night sweats and weight loss occurred in more than half the patients. The erythrocyte sedimentation rate (ESR) was elevated in 95% and no patient tested had a negative Mantoux test. In 20 patients diagnosis was by clinical suspicion and response to therapeutic trial. In 52, including 39 who had a laparotomy, histological and culture material was obtained but these patients fared no better. Only one organism was resistant (to streptomycin) and rapid response to chemotherapy was the rule. Successful outcome was not related to the type of presentation, operative findings or specific chemotherapeutic agents. We would suggest that in Asians presenting with difficult-to-diagnose abdominal symptoms accompanied by malaise, raised ESR and a positive Mantoux test, a therapeutic trial of anti-tuberculous therapy should precede diagnostic laparotomy.
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PMID:Abdominal tuberculosis in East Birmingham--a 16 year study. 365 61


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