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

Information from 2 recent books on the most common abortion techniques is presented. Menstrual aspiration can be performed up to 14 days after a missed period. A flexible plastic cannula 4-5 mm in diameter is passed through the cervix to the uterus, and the contents are evacuated using a syringe. Little dilatation is required and the procedure is done under local anesthesia. Aspiration through the 12th week is usually done under general anesthesia using a cannula and mechanical aspiration. A curette is used to assure that the abortion is complete. Local anesthesia is used in some places. From 12-16 weeks a combination of scraping and aspiration is used with general anesthesia and sometimes forceps. The uterine cervix requires greater dilatation. After 16 weeks the amniotic fluid is removed and a solution of salt and water is injected into the woman under local anesthesia. Contractions begin about 24 hours later. Labor may also be induced by oxytocin or prostaglandins which result in 8-15 hours of labor. This method of abortion probably causes the greatest amount of anxiety in the patient. Uterine scraping is described in the 2nd book as a procedure in which the cervix is progressively dilated with metal instruments of different sizes until it is sufficiently dilated to permit passage of the curette. Laminaria tents were previously placed in the cervix 24 hours prior to the abortion to achieve slow and progressive dilatation. General anesthesia is required because cervical dilatation is painful. In uterine aspiration the contents of the uterus are removed using tubes called Karmen cannulas. It is sometimes possible to avoid cervical dilatation by using thin cannulas, in which case general anesthesia may be avoided. After the aspiration the uterus may be scraped to assure the complete removal of the uterine contents. Prostaglandins may be used to initiate uterine contractions leading to expulsion of the uterine contents during the 2nd trimester of pregnancy. The procedure may cause significant side effects. Other procedures consist of injecting various substances into the uterine cavity during the 2nd trimester of pregnancy. Hysterotomy involves surgical opening of the abdomen and is analogous to cesarean section. Possible complications of an induced abortion include uterine perforation, bleeding, infection, and in extreme cases maternal death through sepsis. Medical attention should be sought in cases of hemorrhage, abdominal pain, fever, or general malaise after an induced abortion.
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PMID:[Literary but technical abortion]. 655 11

Although Wilson's Disease is a treatable disorder, 9 of 15 cases referred with undiagnosed liver disease in the present series died in 3 to 53 days of admission. We have reviewed these cases to identify features that would allow earlier diagnosis and improvement in management. The presenting symptoms were lethargy and malaise (11 cases), jaundice (11), abdominal pain (9), and deteriorating school performance (4). At diagnosis, all fatal cases had jaundice and ascites, while only one of the 6 survivors had ascites and two had jaundice. Evidence of hemolysis was found in 3 fatal cases and 5 survivors. Serum bilirubin concentrations, aspartate transaminase, and prolongation of prothrombin time were significantly more abnormal in the fatal cases (p less than 0.01) as compared with the survivors. Cirrhosis was present in all fatal cases and in 2 of the 6 survivors. Wilson's Disease must be excluded in children presenting with frank liver disease as well as those with hemolytic anemia, persisting lethargy, abdominal pain, or deteriorating school performance.
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PMID:Wilson's disease in childhood. Variability of clinical presentation. 661 55

Praziquantel is a newly developed drug effective in the treatment of schistosomiasis. In order to assess the efficacy and toxicity of praziquantel in the treatment of Schistosoma mekongi, 11 infected Laotian refugees, all belonging to a single extended family, were treated in a double-blind crossover trial with praziquantel and placebo. Initially, one group of five received praziquantel 60 mg/kg body weight in three divided doses orally while the remainder received an identically appearing placebo. Patients were evaluated clinically before, during and following therapy for 2 days. After 2.5 months the patients were re-evaluated and subjected to the opposite treatment, and final follow-up took place 5-7 months later. Three other patients were treated using an open protocol. All but one person was cured (91%). This patient failed to show a decrease in egg excretion 2.5 weeks after praziquantel therapy and was lost to follow-up thereafter. Side effects were common and consisted primarily of abdominal pain, malaise, and fever. These were generally mild and transient. No abnormal laboratory findings were associated with praziquantel therapy. At the final evaluation 6/6 patients with initial hepatomegaly showed a decrease in liver size.
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PMID:Treatment of Schistosoma mekongi with praziquantel: a double-blind study. 675 Nov 16

A 27-year old woman admitted to the hospital after 5 days of vaginal bleeding at 12 weeks gestation had had a copper-T IUD inserted 10 months previously. The IUD string was no longer visible at pregnancy testing. Prior to admission she had experienced lower abdominal pain, increasingly heavy vaginal bleeding, fever, malaise, chills, and vomiting. Intravenous ampicillin and metronidazole were commenced and the uterus was evacuated under a general anesthetic. The copper-T was removed from the uterine cavity. A uterine swab at operation and preoperative blood cultures grew E. coli. A moderate degree of disseminated intravascular coagulation (DIC) was indicated by a coagulation profile. The case demonstrates that the copper-T may be associated with intrauterine sepsis and DIC. In the 1st trimester the risk of abortion following removal of a device is near 30%, while the rate of abortion for women in whom the string is no longer visible is near 48%. Patients presenting with pregnancy in the presence of an IUD and symptoms of sepsis should have the uterus evacuated under suitable antibiotic cover.
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PMID:Septic abortion in an IUCD user. 676 7

The medical records of all patients with diffuse histiocytic lymphoma (DHL) presenting for treatment at the Stanford University Medical Center between 1970-1978 were reviewed. From this group of 284 patients, 48 were identified with gastrointestinal tract lesions at initial evaluation. Abdominal pain was the most common presenting symptom. Anorexia, weight loss, malaise, and weakness were also common complaints. Twenty percent of these patients noted abdominal masses and 15% experienced gastrointestinal bleeding. Gastric involvement was found in 56% of patients, small intestine in 25%, large intestine in 10%, and pancreas 8%. Following treatment, 83% of Stage IE patients, 43% of Stage IIE patients, and 27% of patients with Stage III and IV DHL achieved durable complete remissions. Considering all stages, a 54% complete remission rate was observed. Of the 26 patients achieving a complete remission, seven have relapsed and the remaining continue free of disease from 6+ to 82+ months. The median survival for patients obtaining a CR was greater than 36 months. Gastrointestinal bleeding or perforation probably as a consequence of therapy was noted 25% of patients. The implications of these findings for improved therapeutic programs and investigations are discussed.
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PMID:Diffuse histiocytic lymphoma presenting with gastrointestinal tract lesions. The Stanford experience. 698 86

Advanced abdominal pregnancy was encounter 10 times in 102,000 deliveries over a period of 10 years at 1 hospital. The clinical features, difficulties in diagnosis and management, and the outcome of this uncommon condition are discussed. The most frequent symptoms encountered in this series were abdominal pain (100%), nausea and vomiting (70%), general malaise (40%), and painful fetal movements (40%). The commonest physical findings were abdominal tenderness (100%), an abnormal fetal lie (70%), and a displaced uterine cervix (40%). The incidence of diagnostic error was 60%. Multiple diagnostic procedures are needed to reduce the incidence of error. The maternal mortality was 20% and the perinatal mortality 40% in this series. The postoperative morbidity and mortality were high when the placenta was left in situ. Methotrexate was used in 5 cases to expedite degeneration of the trophoblastic tissue in the residual placenta. The value of this drug in managing the abdominal placenta could not be established. Removal of the placenta, when it is safely possible, gives the best results.
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PMID:Advanced abdominal pregnancy--observations in 10 cases. 707 83

Four cases of primary splenic hemangiosarcoma are described. The most common presenting symptoms were recurrent, fever, malaise, and abdominal pain. Three patients also had complaints referable to the urinary tract. Severe hemolytic anemia with bizarre or fragmented red blood cells on peripheral smear was noted in three patients, in two cases, for more than 1 year before diagnosis. Two patients had been treated for mammary carcinoma with ionizing radiation 10 years before developing hemangiosarcoma of the spleen. One patient had multiple congenital hemangiomas present from birth, and is thought to have developed hemangiosarcoma in a previously existing benign hemangioma. None of our patients survived more than 7 months after the diagnosis of hemangiosarcoma. The importance of early detection and treatment of this tumor is discussed.
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PMID:Primary hemangiosarcoma of the spleen: report of four cases. 719 86

A survey carried out in the Shimshon family health centre in the rural area of Jerusalem revealed that 24 per cent of new patient-doctor contacts were for psychosomatic disorders.The three major. disorders-back pain, headache and abdominal pain-were present in almost 79 per cent of all psychosomatic contacts. Other common disorders were chest pains, palpitations, malaise and nocturnal enuresis. Classic illnesses such as peptic ulcer or asthma were less common. The incidence of peptic ulcer, asthma, atopic dermatitis and chest pains was higher among males than females; rates for headache, palpitations and malaise were higher for females than males. Back pain, headache and abdominal pains occurred differently among the five ethnic groups of the study population. Therapeutic care is carried out through assessment and study of the patient and his or her family.
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PMID:Psychosomatic disorders in a rural family practice in israel. 727 96

The early clinical features, primary care, treatment and short-term prognosis in 15 cases of acute myocarditis where diagnostic confirmation was made by endomyocardial biopsy or autopsy were analyzed. Characteristically, idiopathic myocarditis of possible viral etiology revealed preceding symptoms which consisted of flu-like symptoms, i.e., fever, upper respiratory infection (sore throat, cough), myalgia or arthralgia, general malaise, and gastrointestinal disorders (vomiting, anorexia, nausea, abdominal pain and soft stool). A severe cardiac or generalized disease condition may follow. Depending upon the progress of intensive medical and cardiac care, the patients' prognosis is not always poor. Diagnostic criteria based upon our own experience have been constructed as a proposal.
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PMID:Early clinical profiles of cases with histopathologically proven acute idiopathic myocarditis and a proposal for diagnostic criteria. 732 Nov 52

Information about epidemiology, natural history and prognostic factors of adrenocortical carcinoma in Italy is extremely scarce. We report here 35 patients of adult age who were referred to our institution in the last two decades. Nine patients had non functioning, and 26 had functioning tumors. In non-functional tumors initial symptoms were abdominal pain in 90% of cases, fever, weakness, malaise, weight loss in 30%. Only one patient was asymptomatic. Of patients with functioning tumors, 18 presented with Cushing's syndrome, 6 with Cushing's syndrome and virilization, 1 with Cushing's syndrome and feminilization and 1 with hyperaldosteronism. Twenty-two of all cases (63%) had metastases at diagnosis; most frequent sites were lung, liver and distant lymph nodes. The results of tumor staging, according to MacFarlane system, were: stage I, 1 patient (3%); stage II, 10 patients (28%); stage III-IV, 24 patients (69%). Twenty-six out of 35 patients underwent removal of the mass with complete adrenalectomy. Twelve patients received mitotane alone; 8 mitotane and chemotherapy; 5 chemotherapy alone; 2 radiotherapy associated with mitotane or chemotherapy; 1 anthalgic radiotherapy. Survival time ranged from 1 to 108 months. One-year survival rate was 60%, and 5-year survival rate was 10%. Lower survival rate compared with that reported from other countries is probably related to the referring of patients at very advanced stages of disease. Early recognition and referral, in addition to optimization of therapeutic protocols by multicenter studies, may improve prognostic aspects.
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PMID:Adrenocortical carcinoma: epidemiology and natural history. 765 Dec 87


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