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

A case of mesenteric arteritis complicating the post-operative coarctectomy in a 5 day old infant is described. This case was of interest due to diagnostic difficulties and the fatal outcome. In order to avoid the disastrous consequences of this syndrome, the following symptoms including fever, intestinal bleeding, ileus, nausea, vomiting, leucocytosis, hypertension or abdominal pain should alert the physicians and treatment should start without delay.
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PMID:Postcoarctectomy mesenteric arteritis presenting as neonatal appendicitis. 51 13

Fibre-optic endoscopy of the upper gastro-intestinal tract has been successfully performed in 55 patients (60 examinations) with one complication related to general anaesthesia. Fifty-six of these examinations were performed under general anaesthesia in children ranging from 1 to 14 years. Four examinations were done without an anaesthetic. The instruments used were the Olympus GIF-K (forward oblique gastroscope) in the older children and the GIF-P2 (end-viewing paediatric gastroscope) in the younger patients. Indications for examination included gastro-intestinal bleeding, confirmation or exclusion of peptic ulceration as suspected on barium studies, persistent and recurrent vomiting, chronic abdominal pain, and the evaluation of gastro-oesophageal reflux. The need for careful selection of patients is emphasized since general anaesthesia is considered essential in the majority of chidren.
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PMID:Upper gastro-intestinal endoscopy in chidren. 55 Apr 8

Malignant tumors of the small bowel are rare but carry a grave prognosis. Thirty-seven cases from the Tumor Registries of Brooke Army Medical Center. Fort Sam Houston, Texas, and Fitzsimons Army Medical Center, Denver, Colorado, were retrospectively studied. Twenty-nine males and eight females ranging from five to 86 years were included in the combined series. Thirteen carcinoid tumors, eight adenocarcinomas, seven lymphosarcomas, five leiomyosarcomas, two reticulum cell sarcomas, one liposarcoma, and one mesenchymal cell sarcoma were found. Symptoms included intermittent crampy abdominal pain, intestinal obstruction, intestinal bleeding with anemia, and weight loss. The diagnosis was made on the basis of the clinical picture in addition to physical findings and pertinent x-ray contrast studies. The overall survival rate was 25%. The treatment of choice is surgical extirpation of the tumor whenever possible followed by appropriate adjunctive modalities.
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PMID:Malignant tumors of the intestine: a review of 37 cases. 57 64

Primary malignant tumors of the small intestine are uncommon. This infrequency and possible lack of awareness can result in a late diagnosis and a poor survival time. In a period of 34 years, only 55 patients were seen at our cancer institute. The average age of the patients was 56 years, with a male predominance ratio of 2.6:1.0. Twenty-one patients had adenocarcinomas, 19 had sarcomas and 15 had carcinoids. The most common signs and symptoms were abdominal pain and obstruction of the intestine. Preoperative diagnosis was established in 12 of these patients only by roentgenologic barium examination of the small intestine. At the time of diagnosis, 34 of the patients had metastasis to regional lymph nodes or distant organs. The median and five year survival times were one year and 19 per cent, respectively. Patients with carcinoids had better survival rates than those with adenocarcinomas or sarcomas. Palliative resection did not improve survival time. However, if other therapeutic modalities also were used, it might prove beneficial. Patients with palpable abdominal masses or intestinal bleeding, or both, had a worse prognosis than did those presenting with obstruction of the intestine because these are late presenting symptoms. Therefore, recurrent abdominal pain should increase clinical suspicion, and early diagnosis by careful examination of the small intestine with barium contrast material could improve the survival time. Finally, it seemed that these tumors had a high incidence of coexisting malignant conditions, as nine of the patients in our series had a second malignant tumor.
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PMID:Primary malignant tumors of the small intestine. 98 48

Poly arteritis nodosa (PAN) is a systemic vasculitis with a male: female ratio of 2:1 and a peak incidence in the fifth decade. Small to medium-sized arteries are involved by focal transmural inflammatory necrosis. Aneurysms with inflammatory destruction of the media also occur. The most frequently involved organs are the kidney, heart, lung, liver, and gastrointestinal tract. There are few reported cases of ischemic necrosis of the intestine and even fewer survivors. A 22-year-old woman was transferred to St. Thomas Hospital (Nashville, TN) after resection of 80 per cent of the small bowel for ischemic necrosis. She had a history of juvenile onset diabetes mellitus, recurrent abdominal pain, and splinter hemorrhages. Emergency aortogram and selective mesenteric arteriogram were performed. The celiac artery was not visualized and small aneurysms were present in the mesenteric and renal arteries. The patient was successfully resuscitated from a cardiac arrest in x ray from a cardiac tamponade. Laparotomy was performed to determine the viability of the bowel. The celiac, hepatic, and splenic arteries were found to be chronically occluded. Pathology of these arteries revealed a nonspecific arteritis. At a third operation, several more inches of small bowel were removed. Characteristic changes of PAN were present on all small bowel specimens. She was treated with high-dose cyclophosphamide and steroids for 6 months and has continued on low-dose cyclophosphamide. She is now 36 months from her original operation and is doing well on oral nutrition. Intestinal hemorrhage from aneurysm rupture or gangrene with perforation are gastrointestinal complications of PAN that the surgeon may be called upon to treat.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Surviving gastrointestinal infarction due to polyarteritis nodosa: a rare event. 134 8

More than 50% of all HIV-infected patients have gastrointestinal symptoms like dysphagia, abdominal pain, diarrhea or intestinal bleeding. We describe an emergency situation with gross gastrointestinal bleeding in a twenty-seven year old drug addicted female. Colonoscopy and histological examination of the biopsies were the main diagnostic procedure to locate an extrapulmonary manifestation of a mycobacterium-tuberculosis-infection.
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PMID:[Primary intestinal tuberculosis in AIDS]. 148 54

Primary neoplasms of the small bowel are unusual and constitute 1-5% of all gastrointestinal tract neoplasms. Preoperative diagnostic difficulties, frequent dissemination at the time of the diagnosis, and poor prognosis are characteristic of this pathology. During a period of 26 years we treated 61 patients with tumors of the small bowel, 44 malignant and 18 benign (1 patient had both). The most common symptoms were abdominal pain (62%), weight loss (41%), and gastro-intestinal bleeding (31%). More than half of the patients were treated as emergencies and among the remaining, the most useful diagnostic test was the small intestinal barium study. Seventeen patients were operated on for intestinal obstruction, 6 of them due to intussusception of the tumor, while 8 other patients presented with perforation and 7 with massive gastrointestinal bleeding. Leiomyoma was the most frequent benign lesion. Among malignancies lymphoma was encountered in 38.6%, followed by adenocarcinoma (29.6%) and leiomyosarcoma (22.8%). Lymphoma was predominant among Sephardic Jews. Curative procedures were attempted in all but one of the benign cases and in 21 of the malignant cases. At the time of surgery metastases were present in 23 patients. The postoperative mortality was high (20% and 14% in the benign and malignant groups, respectively) most probably due to the high incidence of emergency surgery in a high risk population. The prognosis of the malignant tumors was poor with a 5-year survival of 18%. Their disappointing course seems to be related to late diagnosis because of nonspecific symptoms and difficulty in bringing the tumor to the fore. Hopefully, a greater awareness will lead to an earlier diagnosis and improve the prognosis.
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PMID:Primary neoplasms of the small bowel. 154 77

A 67 year old female patient came to admission because of colic abdominal pain and suspicion of intestinal bleeding. Coloscopically we found disseminated ulcerations within hemorrhagic swollen mucosa at left flexure, right and lower colon were without pathological finding. We thought of ischemic colitis and performed endoscopic dopplersonography. A reduced flow noise over the anastomotic loop between upper and lower mesenteric artery was evident. By means of histology and radiology ischemic colitis was confirmed and after therapy cicatrical healing resulted. As far as we know for the first time ischemic colitis could be recognized with endoscopic dopplersonography.
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PMID:[Doppler ultrasound detection of ischemic colitis]. 159 16

Thirty duodenal and three upper-jejunal endocrine tumors are reported. Clinical manifestations included: a) the Zollinger-Ellison syndrome (10 cases); b) peptic ulcer disease in which hypergastrinemia was not documented (3 cases); c) cholestasis or cholelithiasis (4 cases); d) abdominal pain (4 cases); e) gastro-intestinal bleeding (1 case); f) celiac sprue (1 case). Ten further tumors were discovered incidentally, at autopsy or in pathological specimens after gastrectomy or duodenopan-createctomy. Histological pattern was trabecular in 19 cases, insular in 2 and mixed in ten cases. Two cases were typical ganglioneuromatous paragangliomas. All tumors were examined immunohistochemically. Twelve tumors contained gastrin, four somatostatin, six both of these peptides, one serotonin, two both gastrin and serotonin, and two tumors contained gastrin, serotonin and somatostatin. Ganglioneuromatous paragangliomas combined somatostatin and/or pancreatic polypeptide containing endocrine cells with protein-S100-positive Schwann cells. In four tumors no peptide or amine was demonstrated. Gastrin cell tumors (63.6% of our cases), both functionally active (gastrinomas) and clinically silent, predominated in the proximal duodenum, while somatostatin cell tumors (15.1%) and paragangliomas were mostly found in the periampullary region. Two tumors were classified as malignant on the basis of lymph node metastases, and both were jejunal gastrinomas associated with Zollinger-Ellison syndrome. Two somatostatin cell tumors had manifestations of von Recklinghausen's disease.
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PMID:Endocrine tumors of the duodenum and upper jejunum. A study of 33 cases with clinico-pathological characteristics and hormone content. 216 Apr 22

The paper reports a case of a 45-year-old female with long-standing anemia, recurrent abdominal pain and subocclusive crises. Following a negative endoscopy of the upper tract of the large intestine, barium enema and angiography, the patient underwent total colonoscopy. Massive bleeding from the ileal valve suggested an ileal pathology: a small intestine enema confirmed a polypoid proliferation 60 cm above the Bahuino valve with related ileal invagination 25 cm long. The patient underwent surgery and pathological findings revealed a 7 cm-wide ileal lipoma near a small angiodysplasia. The latter seemed to be the cause of bleeding. The diagnosis of small intestine tumours is made difficult by the fact that the only important signs are abdominal pain, intestinal bleeding and subocclusive crises, which are common symptoms in many pathologies. The authors stress the importance of a thorough endoscopic examination and selective angiography.
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PMID:[Lipoma of the small intestine. A clinical case]. 233 68


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