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

A 46-year-old man with myeloproliferative disorder received a stem cell transplant from an HLA-identical unrelated donor. Eight months status post transplantation, during the course of tacrolimus therapy, the patient developed severe epigastric pain and fever. FGS findings showed eruptions with blisters in the esophagus and ulcers in the stomach. Biopsy specimens revealed acidophilic inclusion bodies in the nuclei. Varicella zoster virus (VZV) DNA copies were detected in the serum. No skin lesions were observed prior to hospital admission. The diagnosis of visceral VZV infection was made and the gastric and esophageal lesions were successfully healed with acyclovir (ACV). Severe abdominal pain is one of the most important signs of VZV infection for recipients of stem cell transplantation.
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PMID:Involvement of the esophagus and stomach as a first manifestation of varicella zoster virus infection after allogeneic bone marrow transplantation. 1549 26

We report herein a rare case of choledochal cyst diagnosed at 14 weeks gestation and treated with percutaneous transhepatic drainage until postpartum. A 26-year-old primigravid woman at 14 weeks gestation presented with epigastric pain, slight fever, and nausea of 3 days duration. Abdominal ultrasonography revealed a 6-cm-diameter cystic mass between the porta hepatis and the pancreas head, which was diagnosed as a type I choledochal cyst. At 18 weeks of gestation, her upper abdominal pain became severe, and the size of the choledochal cyst increased to 12 cm in diameter. Laboratory data revealed a biliary obstruction. Percutaneous transhepatic drainage was performed immediately. She delivered a healthy male baby by elective cesarean section at 37 weeks of gestation. At 6 weeks postpartum, the patient underwent surgical excision of the choledochal cyst, cholecystectomy, and formation of a Roux-en-Y hepaticojejunostomy. Although choledochal cysts are rare during pregnancy, obstetricians should be familiar with the condition to ensure prompt diagnosis and adequate definitive management, given that the implications of missed or delayed diagnosis may be detrimental to both mother and fetus.
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PMID:Choledochal cyst diagnosed and conservatively treated during pregnancy. 1558 May 42

Bezoar is described as presence of indigested or poorly digested material forming a mass in the gastrointestinal lumen. Patients may present with abdominal pain, dyspeptic complaints, gastrointestinal obstruction, perforation or bleeding, as well as, incidental abdominal mass in asymptomatic patients. We report a 30-year-old female patient with no history of previous illness who was presented to the emergency ward with complaints of epigastric pain and abdominal bloating. The diagnostic features and treatment of bezoar are presented.
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PMID:An unusual etiology of epigastric mass. 1575 66

Compression of the celiac trunk commonly occurs in young men and women as well. Most of the patients suffering from this rare disease derive from a large pool of people having diffuse and chronic abdominal complaints including epigastric pain, postprandial abdominal pain and diarrhea leading to weight loss. Aim of the study was the finding of true criteria which can guarantee a successful operative procedure. A major issue in preoperative assessment is color flow Duplex imaging of the celiac axis. The most important finding aside from clinical symptoms is a peak flow in the celiac axis of more than 200 cm/s during inspiration and expiration position of the diaphragm. In addition arteriography of the celiac axis and superior mesenteric artery (SMA) showing a steal phenomenon is essential. Because of the rareness of the disease "only" 15 patients were operated on including intraoperative balloon dilatation of the celiac trunk. 93 % had a long term follow up success. Normal values of peak flow velocity in the mesenteric arteries were determined in more than one hundred healthy persons and compared to findings in the literature which were nearly identical. As a result of the study it could be shown that a successful outcome of the operative procedure can be expected when certain essential criteria are observed: 1. peak flow velocity in the celiac trunk higher than 200 cm/s during in- and expiration 2. steal effect via pancreatic arcades from the superior mesenteric artery documented by Duplex ultrasound and arteriography 3. triad of symptoms: epigastric pain, postprandial pain and weight loss of more than 5 kg. Special emphasis is given to the possible occurrence of severe complications after liver transplantations and pancreatic surgery, if the diagnosis "median arcuate ligament compression" is not known.
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PMID:[Celiac trunk compression: angiographic phenomenon or cause of ischemic abdominal complaints?]. 1596 75

Mesenteric inflammatory veno-occlusive disease (MIVOD) is a relatively recently known and not very often diagnosed form of ischemic bowel disease of low incidence und unknown etiology. We present the case of a patient who after presentation of inconclusive signs of epigastric pain and rectal bleeding suddenly developed right abdominal pain with local peritonism. Suspecting intestinal ischemia or perforated appendicitis we first performed laparoscopy, which showed an inflammable tumor of cecum, ascending colon and appendix with massive adhesions to the abdominal wall. We performed an open right hemicolectomy with primary anastomosis. The patient developed a deep vein thrombosis of the vena tibialis post. and vena saphena parva. After 12 months our patient is free of complaints and recurrence. Investigations carried out showed no evidence of hypercoagulopathy. The presentation of MIVOD can range from chronic inflammatory bowel disease with recurrent abdominal pain in combination with nausea, emesis and bloody diarrhea to acute abdomen. Therefore diagnostic misinterpretation and mistherapy as well as underdiagnosis is common. Histologic investigation shows a variable inflammatory infiltration of multiple veins of the intestinal wall and the mesentery as well as thrombotic vessel occlusion in different stages without involvement of the arteries. All forms of hypercoagulopathy, parasitic disease, sepsis and malignancy have to be excluded. Therapeutic success can only be achieved with surgical resection of the affected bowel, whereon in general no recurrence will occur.
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PMID:[Mesenteric inflammatory veno-occlusive disease (MIVOD)--a rare cause of intestinal ischemia]. 1639 91

Liver abscess can be caused by bacterial, parasitic, or fungal infection. Amebic abscesses are more common, but pyogenic abscesses account for three quarters of hepatic abscess in developed countries. Most common pathogens of the pyogenic liver abscess are Escherichia coli, Klebsiella pneumoniae, Bacteroides, Enterococci, Streptococci, and Staphylococci. However, liver abscess caused by Salmonella species has rarely been reported. We experienced a case of Salmonella liver abscess which improved after antibiotic therapy and percutaneous drainage. The patient was 52 years-old man who had an episode of intermittent fever, chills and epigastric pain for 2 weeks. He was diagnosed as liver cirrhosis eight years ago and diabetes three years ago. Salmonella group D, non-typhi was cultured from blood and pus from the liver respectively at the same time. With percutaneous drainage and susceptible antibiotic therapy, liver abscess decreased in size with improvements in fever and abdominal pain.
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PMID:[A case of Salmonella liver abscess]. 1663 85

Biliary colic is the most common clinical presentation of symptomatic gallstone disease, whatever its localisation (cholelithiasis or choledocolithiasis). The pain of biliary colic is unfortunately called "colic", a word suggesting paroxystic bouts and usually described as localised in the right upper quadrant. In fact, biliary pain is most frequently epigastric in location, usually starts abruptly to generally persists without fluctuation and resolve gradually over two to four hours. Biliary lithiasis has a high prevalence in the population, especially in elderly women but only 20% of the patients are symptomatic and among them, only 10 to 20% experience severe pain. Misdiagnosis is frequent with potential disastrous implications, especially with other causes of epigastric pain (atypical myocardial ischemia, perforated ulcer, etc.). Non invasive imaging of the biliary tract is now generally easy to obtain; abdominal ultrasound for gallbladder stones and magnetic resonance cholangiography for the main bile duct and the intrahepatic bile ducts. But, for gallbladder stones, the greatest care must be taken by the radiologist to link up the symptomatology and the cholelithiasis. Precise description of the abdominal pain (nature, intensity, location, duration, irradiation...) is needed and must be searched by the radiologist to prevent misdiagnosis.
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PMID:[Biliary colic: imaging diagnosis]. 1669 Nov 73

We report on a 54-year-old male patient with an aggressive T cell non-Hodgkin's lymphoma with abdominal manifestation undergoing autologous peripheral blood stem cell transplantation after high-dose chemotherapy in April 2003. About 4 months after transplantation, he developed severe upper abdominal pain. Ultrasound examination, X-ray, computed tomography of the abdomen and cardiac diagnostics could not explain the symptoms. While empiric therapy with high-dose acyclovir was started, we could document herpetic lesions in the gastric antrum by endoscopy. The epigastric pain rapidly decreased within several days after the start of acyclovir therapy. No herpetic skin lesions were observed at any time during the disease. This report demonstrates the importance of viral-induced gastritis in the differential diagnosis of severe abdominal pain in patients receiving autologous peripheral blood stem cell transplantation.
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PMID:Acute abdomen by varicella zoster virus induced gastritis after autologous peripheral blood stem cell transplantation in a patient with non-Hodgkin's lymphoma. 1680 91

A 17-year-old adolescent girl from El Salvador presented to the emergency room (ER) with severe abdominal pain associated with one episode of nausea and vomiting. The pain that started 5 days earlier was sharp in nature and epigastric in location with radiation to back and was relieved by half a tablet of Vicodin. The patient has a history of intermittent epigastric pain for the past 2 years and was treated for Helicobacter pylori for 1 year. In the ER, the serum chemistry demonstrated elevated amylase. Further workup with abdominal ultrasonography (US), computed tomography (CT), magnetic resonance cholangiopancreatography (MRCP), and hepatobiliary scintigraphy confirmed a type IV-a choledochal cyst with intra- and extrahepatic dilation of bile ducts. We report an unusual acute abdomen presentation of type IV-a choledochal cyst in a 17-year-old young adult from El Salvador.
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PMID:Type IV-a choledochal cyst--a rare adolescent presentation as acute abdomen. 1690 61

We report two cases of malignant afferent loop obstruction following pancreaticoduodenectomy (PD). Case 1. A 70-year-old woman, who had undergone PD for pancreatic cancer, was referred to our hospital because of fever, jaundice, and abdominal pain. Ultrasonography and abdominal computed tomography demonstrated dilatation of a small bowel loop in the right upper quadrant. Laparotomy confirmed the diagnosis of local recurrent tumor causing occlusion of the afferent limb, and Roux-en-Y bypass was performed. Case 2. A 72-year-old man, who had undergone PD for cancer of the major papilla, was hospitalized with a high-grade fever and epigastric pain. Ultrasonography and abdominal computed tomography revealed a dilated afferent loop and multiple masses in liver. At laparotomy, widespread carcinomatosis was found to have caused afferent loop obstruction, and surgical bypass was performed. In conclusion, the surgical bypass seems to be an effective palliative treatment for afferent loop syndrome after PD.
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PMID:Malignant afferent loop obstruction following pancreaticoduodenectomy: report of two cases. 1693 49


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