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

Bleeding pseudocysts respectively pseudoaneurysms represents a seldom complication of chronic pancreatitis in owing to erosion of pancreatic or peripancreatic arteries. The potential rupture into neighbouring organs or in the peritoneal cavity is accompanied with paramount life-threatening risks. During the last years we observed 3 patients with acute intestinal bleeding caused by pseudocysts converted to pseudoaneurysms. The goal of our report is to analyze the diagnostic tools and the management of patients with bleeding pancreatic pseudocysts, also well establish the clinical constellation, which is typical for this complication, the best diagnostic tool and the modalities to immediate control of the acute bleeding situation. All three patients suffered from chronic pancreatitis and alcohol abuse. The first patient had a known pancreatic pseudocyst, which penetrated through the gastric wall and caused a life-threatening bleeding. The second patient was admitted in owing to melena. The examinations yielded a pancreatic pseudocyst with hematosuccus pancreatis. The third patient suffered from abdominal pain and vertigo caused by anemia. With endoscopy, Cat and celiacography a pancreatic pseudocyst with cysto-colic fistula has been identified. The color-doppler ultrasound revealed a pseudoaneurysm supplied from a splenic artery branch. With management of these patients with hemorrhagic complications of pancreatic pseudocysts we acquired the following findings: 1. Patients with known chronic pancreatitis and abdominal tumor, especially when accompanied by epigastric pain and anemia, are highly suspicious for pancreatic pseudoaneurysms. 2. The color-doppler ultrasound is the best diagnostic tool, since this investigation can establish the pseudoaneurysm and identify the source.
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PMID:[Hemorrhage from pseudocysts caused by pseudoaneurysms in chronic pancreatitis. Diagnosis and management]. 837 41

To summarize, it has been argued that: 1. The assessment of complaints about crying and colic present particular diagnostic problems. 2. The crying brought as a complaint seldom indicates disease. 3. Once clinical disease has been ruled out, the clinical meanings of normality and abnormality no longer apply. 4. At that point, one should not try to determine a "cut-off" point for abnormal crying, because (a) it is unhelpful clinically, (b) it is wrong in principle, and (c) it is not likely that any specific amount of crying is normal or abnormal, independent of context. 5. As a possible alternative, it is proposed that we should think of the behavior not a symptom of something the infant "has," but as something the infant "does." This behavior may have consequences that are functional or dysfunctional for the infant, the caregiver, or the infant-caregiver interaction. If this argument has merit, it may have some interesting and important implications for the way we think about, treat, and investigate developmental and behavioral problems including (but not limited to) infant crying and colic. First, what holds true for crying and colic may also hold for bedwetting and enuresis, overactivity and attention-deficit hyperactivity disorder, and abdominal pain and recurrent abdominal pain syndrome, to name just a few. As a brief test of their applicability, one might ask how often organic disease is found in these entities, or how often patients are investigated and treated because an arbitrary amount of these behaviors is taken to be "excessive" or abnormal.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Normality: a clinically useless concept. The case of infant crying and colic. 840 70

A 5-week-old belgian colt was examined for colic of 12 hours duration after several episodes of diarrhea. Physical examination revealed signs of abdominal pain, mild dehydration and normal auscultable borborygmi in all abdominal quadrants. Distention of the cecum, large colon and small intestinal was evident on abdominal radiographs. The foal was treated medically as the owners declined surgery. The colt was euthanized because of continued deterioration and failure to respond to medical therapy. Post-mortem exam revealed the presence of a trichophytobezoar obstructing the distal part of the transverse colon.
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PMID:Trichophytobezoar as a cause of transverse colon obstruction in a foal. 846 3

During a 5-year experience in Central Africa, the most common cause of 78 adult intestinal obstructions was primary adult cecal-colic intussusception (n = 43; 55%). The symptom complex of colicky abdominal pain and obstipation was present in 100% of the patients with intussusception. Operative repair in 90% of patients consisted of simple reduction of the intussusceptum. There were no known recurrences. The etiology of adult cecal-colic intussusception is unknown. Patients typically present with a 3- to 4-day history of abdominal pain, obstipation, and usually a palpable mass. Treatment is surgical reduction. Right colectomy is reserved for intestinal gangrene. We treated 43 cases during a 5-year period with only one death.
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PMID:Cecal-colic adult intussusception as a cause of intestinal obstruction in Central Africa. 866 42

The analgesic effect of N-butylscopolammonium bromide (0.3 mg/kg) using a balloon-induced model of colic in ponies was evaluated and compared with butorphanol tartrate (0.1 mg/kg). Eight adult ponies were used and each received both treatments during the two different trials. The order in which the treatment was received was randomly assigned. At the start of each trial, moderate abdominal pain was induced by inflation of a balloon placed in the lumen of the caecum. The ponies were evaluated every 5 minutes, and a cumulative pain score (CPS) was assigned. Two baseline measurements were recorded, followed by the administration of one of the two treatments. Assessments were continued for 60 minutes, or until moderate abdominal pain returned. Three ponies out of 8 responded to treatment with butorphanol tartrate, while 6 out of 8 ponies responded to N-butylscopolammonium bromide. There were no statistical differences in the CPS or duration of drug action between treatments.
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PMID:A comparison of N-butylscopolammonium bromide and butorphanol tartrate for analgesia using a balloon model of abdominal pain in ponies. 882 97

Although Crohn's disease (CD) is generally found in the ileum and/or colon, since the 1960s it has become evident that this chronic inflammatory disorder of unknown aetiology can affect the whole gastrointestinal tract from mouth to anus. In 0.5-13% of patients with ileocolonic CD the disease occurs in the upper gastrointestinal tract as well (i.e., from mouth through jejunum). With the radiological double-contrast technique, however, early signs of upper gastrointestinal CD may be detected in 20-40% of patients with ileocolitis. On the other hand, histologically evaluated biopsies from the lower oesophagus, body of the stomach, gastric antrum and the duodenal bulb of patients with Crohn's disease from whom the upper gastrointestinal tract is normal, according to X-ray or endoscopy may reveal lesions, which are considered to be pathologically diagnostic. Jejunal involvement occurs in 4-10% of patients with ileitis, ileocolitis or colitis. In early studies biopsies of apparently normal buccal mucosa from patients with Crohn's disease showed a significant correlation between the activity of the disease, as defined by the Crohn's Disease Activity Index, and the number of plasma cells containing IgM, suggesting a generalized activated humoral defence system during relapse. A diagnosis of Crohn's disease of the upper gastrointestinal tract can be achieved by combining recognition of clinical, roentgenographic, and endoscopic features. Provided that other causes of granulomatous involvement of the gastrointestinal tract can be excluded, non-caseating granulomas are generally accepted as the histological proof of Crohn's disease. When Crohn's disease does involve the upper gastrointestinal tract, there is nearly always concomitant disease in the small bowel or colon. Compared to patients with an ileocolonic localization, patients with Crohn's disease in the upper gastrointestinal tract more frequently have colic-like abdominal pain and/or cramps, nausea and anorexia as presenting symptoms and are younger at onset of the disease. Medical therapeutic principles are the same as for Crohn's disease elsewhere in the gastrointestinal tract. Absolute indications for surgical treatment are massive bleeding, progressive stenosis, and extensive fistula formation.
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PMID:Crohn's disease of the upper gastrointestinal tract. 905 Mar 25

Enlarged anorectal lymph nodes can cause colic in young horses by obstructing the caudal aspect of the rectum. Dyschezia and clinical signs consistent with abdominal pain were the predominant reasons for evaluation of the 5 young (3 to 15 month old) horses of this report. Digital transrectal palpation revealed a firm mass obstructing the caudal aspect of the rectum in each horse. Results of cytologic evaluation of the masses revealed a lymphoid population of cells in 4 of 5 horses. These nodes regressed over time or became abscesses and drained into the rectum. In 1 horse, detection of a mature abscess and concomitant dysuria necessitated immediate surgical drainage of the mass; however, the other 4 horses were successfully managed medically, thereby avoiding risks associated with surgery of the perirectal area. Anorectal lymphadenopathy should be considered as a differential diagnosis in young horses with colic.
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PMID:Anorectal lymphadenopathy causing colic, perirectal abscesses, or both in five young horses. 907 84

The observation of a case of intestinal intussusception caused by lipoma of the colon prompted the authors to review the literature on the subject and to examine the main characteristics of lipoma of the colon which represent the most frequent benign neoplasia of the large intestine after adenomatous polyps. Lipomas of the colon are localised in 90% of cases at the submucous level, are usually solitary, of varying size and may be sessile or pedunculated. They are almost always asymptomatic; only when they are of a reasonable size do they become manifest following alterations of the alveus, rectorrhagia, abdominal pain or the occupation of the colic lumen by the mass, or intestinal intussusception caused by the progression of the pedunculated lipoma. This difficult diagnosis may be aided by colonscopy with biopsy and dual contrast opaque enema. The prognosis of the disease depends on the presence or absence of complications and, in the case of the former, on early diagnosis and treatment. Lipoma of the colon of less than 2 cm may be electively removed endoscopically, those greater than 2 cm by laparotomy or laparoscopy. In emergency cases, it is advisable to perform a more or less extensive resection of the colon depending on the size of the tumour. In the case reported by the authors, an intussusception manouevre was first performed followed by left segmentary colectomy.
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PMID:[Intestinal invagination caused by colonic lipoma]. 908 38

In this uncontrolled clinical study 12 investigators cooperated to evaluate the analgesic and sedative effect of detomidine (DORMOSEDAN; Farmos Group Ltd; Finland) in 234 horses with abdominal pain caused by colic. The study was designed to use each animal as its own control and to evaluate its response to the drug over a 60 min period. Detomidine was given intravenously (i.v.) once in 169 cases (167 horses, 1 mule, 1 donkey) at a dose of 20 micrograms/kg bodyweight (bwt), and to 65 horses at 40 micrograms/kg bwt. The higher dose was used predominantly in horses with severe pain which were more often in poor health and therefore given a poor prognosis. Sedation and analgesia, rated as satisfactory or highly satisfactory, was achieved in 96 per cent of cases, without obvious differences between doses, sex, breed and species. First clinical signs of sedation and analgesia were recorded within 2.5 and 3.2 mins, respectively, and deep sedation and analgesia were achieved by 4.2 and 5.1 mins. Objective evaluation of analgesia was based on clinical scores related to behaviour (eg sweating, kicking, pawing, head and body movement, stretching, lip curling, attitude and appetite). In five of seven of these parameters the 40 micrograms/kg bwt treatment scored higher initially (P < 0.001) and took longer to return to normal. Although most cases treated with 20 micrograms/kg bwt returned to almost normal levels by 15 mins, those treated with 40 micrograms/kg required 30 mins. Animals not responding to either dose of detomidine went to surgery and/or were destroyed. These involved intestinal strangulation, incarceration, and torsion or rotation of the intestinal tract. No differences were found between doses in the occurrence of side effects. As expected, heart rates and respiratory rates decreased and recovered slowly. Other side effects were recorded in approximately 37 per cent of cases and consisted of instability (27.1 per cent of all other side effects), sweating (14.5 per cent), cardiovascular abnormalities (arrhythmias: 15.1 per cent) and abnormal reactions to sensorial stimuli (6.6 per cent). Less than 20 per cent of the side effects were classified as 'strong' or 'very strong' and none was considered serious. No deaths were attributed to the drug.
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PMID:Field trial evaluation of detomidine as a sedative and analgesic in horses with colic. 911 92

We reviewed the records of 22 patients hospitalized at onset or first presentation of Crohn's disease after age 50. There were 12 females and 10 males, and the mean age was 64.5 years. The most common presenting symptoms were: abdominal pain, fever, diarrhea and weight loss. The disease was located in the small bowel in 14, in the ileo-colic region in 3 and in the colon in 5. The median interval from onset of symptoms until diagnosis was 42 months. 12 (54%) underwent surgery. All 5 patients with colonic disease were operated. 6 patients underwent small bowel resections, mostly terminal ileum, while 1 had resection of both terminal ileum and left colon. The recurrence rate was 70% in the medically treated and 50% in those operated. 1 patient died after surgery for Crohn's disease (4.5%), and 3 others died of unrelated causes. Compared to younger patients, the symptomatology, clinical course, need for and response to surgery, and its complications, did not differ in these older patients, but the recurrence rate seemed to be higher.
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PMID:[Is Crohn's disease different in the elderly?]. 911 6


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