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

Extracorporeal shock-wave lithotripsy (ESWL) was first applied for calculi of the bile duct system in 1985. Recent improvement of the crushing apparatus has enabled us to crush the biliary calculus more accurately than before, and moreover, to conduct the procedure without anesthesia, and to treat easily. We performed ESWL in 30 cases of calculus in the cholecyst using MPL-9000 (Dornier Co., Ltd.) which is said to be a crushing device of a new generation. Here, the study is presented. The results of crushing effect demonstrate the efficacy in 26 of 30 cases (87%), and disappearance rate in 18 cases (60%) at present after an average follow-up period of 4.4 months. The disappearance cases were mainly those with a single calculus (75% disappearance rate) or pure cholesterol calculus (100%). Concerning the complications, right upper abdominal pain which was expected to accompany excretion of the crunched fragments was recognized in 10 cases (33%), it was not seen in cases in which laparotomy or endoscopic papillotomy was performed.
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PMID:[Cholecystolithotripsy using extracorporeal shock waves]. 262 24

Twenty-four pregnant women with acute appendicitis received exploratory laparotomy during an 8-year period. Abdominal pain accompanied with nausea and vomiting were the most common symptoms. Abdominal tenderness and rebounding pain were the most reliable physical signs. Leukocytosis with WBC count greater than 15,000/cu mm and granulocytes greater than 87% and prolonged symptomatic duration were indications that appendiceal perforation might have occurred. A McBurney's incision and spinal anesthesia were preferred for appendectomy during pregnancy. In cases of uncomplicated appendicitis, tocolytic agents and antibiotics were not routinely used. Premature labor occurred in 21% of patients during postoperative period.
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PMID:Appendicitis during pregnancy. 263 59

A 53-year-old woman experienced an acute onset of flaccid weakness of the legs associated with severe abdominal and lower limb pain. Sensory loss extended from L3 to S5. Constipation, recurrent abdominal pain and urinary retention were problems during the course of her illness. Six months after the onset the patient could walk with assistance. A myelogram and CT scan of the lower dorsal and lumbar spine showed no abnormality. Magnetic resonance imaging confirmed the diagnosis of infarct of the conus medullaris. This case highlights the clinical features of spontaneous infarction of the conus medullaris and emphasises the value of magnetic resonance scanning for the diagnosis of lesions of the spinal cord.
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PMID:Infarction of the conus medullaris--clinical and radiographic features. 264 30

Since the first paravertebral blockade was carried out by Sellheim in 1905, this method has proved effective for the isolated blockade of spinal nerves. The efficacy of preoperative intercostal blockade (ICB) in combination with neuroleptanalgesia (NLA) or Pentothal-pentazocine-N2O anesthesia (Pe-Pz) was studied (unilateral analgesia for cholecystectomy). Group 1: NLA; group 2: NLA with ICB; group 3: Pe-Pz; group 4: Pe-Pz with ICB. The analgesic requirement differed significantly between groups 1 (0.33 mg fentanyl) and 2 (0.15 mg fentanyl) and groups 3 (63.5 mg pentazocine) and 4 (31.5 mg pentazocine). There were also significant differences in circulatory responses. The maximum deviation from the initial value at the beginning of the operation in group 1 compared to group 2 was pulse rate + 28.7% vs + 2.4%, mean arterial pressure (Part) + 24.6% vs + 3.1%, and systolic pressure (Psyst) + 33% vs +/- 0%; group 3 compared to group 4: pulse rate + 16.4% vs + 3.2%, Part + 24.5% vs 0.0%, and Psyst + 26.5% vs + 196. The times of action of ICB extended from 7.54 h to 11.33 h for partial analgeisa, time to the first dose of analgesic from 12.3 h to 16.9 h (etidocaine 0.5% and 1% respectively without and with epinephrine). The mean blood levels after 100 mg bupivacaine-CO2 rose to 1.16 micrograms/ml after 5 min and reached a maximum after 15 min (1.29 micrograms/ml) as compared to 0.98 micrograms/ml after addition of ornithine-vasopressin. These values are very much higher than those after the use of bupivacaine-HCl solution. Etidocaine and bupivacaine-HCl have comparable durations of analgesia. Toxicologically, both substances can be applied safely with consideration of all pharmacological data for ICB. Of a total of 3,485 intercostal blockades, 2,775 were applied perioperatively (pre- and postoperatively); 265 were carried out for trauma patients (rib fractures) and 445 for therapeutic indications (herpes zoster neuralgia, tumor pain, costovertebral pain). In 8 blocks 10% ammonium sulfate, in 4 blocks absolute alcohol, and in 19 blocks 5% phenol were used for neurolysis. In 2 cases a marginal pneumothorax was seen, which was resorbed spontaneously (0.06%). Altogether 16,270 single intercostal nerves were blocked. Single-session intercostal blockade can be combined as unilateral analgesia with general anesthesia. This combination is characterized by stable circulatory conditions with avoidance of hypertensive reactions. The long-lasting analgesia allows early mobilization and physiotherapy both postoperatively and posttraumatically in patients with unilateral thoracic and abdominal pain.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[The single intercostal block--surgical and therapeutic indications]. 264 21

The report concerns 162 patients suffering from severe upper abdominal pain without organic findings on routine GI-exploration. Palpation of the abdominal wall revealed well localised pain maxima which appeared to correlate with the distribution of intercostal nerve endings. Exploratory local anaesthesia was able to relieve these symptoms whereby - much to our surprise - the therapeutic effect very often outlasted by months and even years the pharmacological effect attributable to the anaesthetic agent. 129 of the 162 patients treated could be significantly improved or even freed of their painful symptoms. Out of the 33 patients with recurring symptoms, three quarters could be cured or significantly improved by separating the subcutaneous fat from the epigastric fascia, thus destroying the cutaneous branches of the intercostal nerves. It seems legitimate to consider the pathogenesis of these symptoms as being due to entrapments of the intercostal nerve endings in the abdominal fascia and it may thus be considered as an organic entity. Diagnosis is relatively easy and without risk for the patient: exploratory local anaesthesia loco dolenti, which in fact may have a long lasting therapeutic effect.
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PMID:[Experiences with the "epigastric pain syndrome"]. 271 41

The purpose of this prospective study, conducted on 88 patients, was to assess the tolerance, efficiency and early complications due to a piezo-electric lithotriptor in the destruction of gallbladder stones. One hundred and sixty one sessions were performed in 82 patients. All patients had symptomatic, uncomplicated lithiasis, the diameter of which was less than, or equal to, 30 mm. All patients had less than 7 stones in a functional gallbladder. In 22 patients, the stones were calcified. Lithotripsies were carried out without anesthesia or premedication, except in an 8-year-old child who had to be anesthetized. In 3 cases it was impossible to visualize the gallstones and in 3 other patients, the procedure was discontinued because of abdominal pain. Following the procedure, biliary pain occurred in 20 per cent of the patients. One patient only had biliary colic with transient anicteric cholestasis. Clinical examination, sonography, biological tests were found to be normal in all other patients. Endoscopic sphincterotomy or emergency surgery was never required. Stones were found to be unaltered in 6 patients following 2 lithotripsy sessions. The 76 other patients had fragmentation of their stones. The free gallbladder rate was 15.8 per cent between 0 and 2 months, 24.6 per cent between 2 and 4 months and 51.3 per cent between 4 and 8 months. These results tend to show that the destruction of biliary stones by piezo-electric lithotriptor is efficient and well tolerated. As repeated routine examinations were always negative, the three-day hospitalisation period no longer seems necessary.
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PMID:[Extracorporeal lithotripsy of gallbladder calculi. Tolerability, complications and early results]. 275 84

The purpose of this retrospective study was to estimate the frequency and severity of anaesthetic complications in patients with Duchenne's muscular dystrophy (DMD). Forty-four boys with DMD were exposed to anaesthesia and surgery 84 times during a period of 22 years (1965-86). The procedures took place at 15 different hospitals. Retrospective examination of the case records showed: 19 cases with local analgesia without any complications, and 18 of 65 general anaesthetics with minor or more serious complications. In ten cases an increase in body temperature above 37.5 degrees C was seen, five had abdominal pain and dark-coloured urine after surgery, and three had a critical perioperative course with a resemblance to malignant hyperthermia. The complications were almost exclusively related to the use of succinylcholine. The use of succinylcholine was dispersed through all ages. Three out of the eight patients with severe complications occurred 1.5, 2.5 and 4 years before the neuromuscular disease was diagnosed. Thus an unusual course of anaesthesia in male children calls for further investigation. Although it has been stated before that succinylcholine is contraindicated in patients with Duchenne's muscular dystrophy, the drug continues to be used.
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PMID:Complications during anaesthesia in patients with Duchenne's muscular dystrophy (a retrospective study) 231 Nov 64

Fibreoptic endoscopy is a highly efficient diagnostic tool which is now being increasingly used in pediatric age group also. However, certain special considerations like the use of special instruments, use of general anesthesia in younger children and various indications of diagnostic and therapeutic endoscopy need to be clearly emphasized. Over a period of 24 months, 132 children underwent upper gastrointestinal endoscopic examination in our section. Diagnostic endoscopy was carried out on 102 occasions and therapeutic on 162 occasions. Most of the children below 3 years of age required general anesthesia for the procedure. Children above 3 years of age could be managed by intravenous diazepam and pentazocine. The commonest cause of upper gastrointestinal bleed in children was variceal (60.6%) followed by erosive gastritis (27.2%). In children with recurrent abdominal pain no underlying cause was detected at endoscopy. Injection sclerotherapy was found to be a safe and effective mean for control of variceal bleed and most of the foreign bodies ingested by children and still lying proximal to 2nd part of duodenum could be successfully retrieved endoscopically.
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PMID:Upper gastrointestinal endoscopy in infants and children. 278 86

To test the hypothesis that the postoperative abdominal pain of tubal occlusion is mediated by prostaglandins, the effects of meclofenamate, an analgesic and a potent inhibitor of cyclooxygenase, on postoperative analgesia and incidence of abdominal pain were compared with those of acetaminophen, a weak inhigitor of prostaglandin activity. 100 patients undergoing tubal occlusion under local anesthesia in a Kentucky health facility were studied. Tge patients were randomly divided into 4 equal groups: 1) control; 2) acetaminophen, 1300 mg; 3) meclofenamate, 100 mg; 4) meclofenamate, 200 mg. The fallopian tubes were occluded by electrocautery in 47 patients and by application of Falope rings in 53 patients. Both acetaminophen and meclofenamate provided substantial analgesia for 4 hours after the operation (p0.05). Meclofenamate reduced the incidence of abdominal pain by 1/2 (p0.02), but acetaminophen did not. These results suggest that a portion of pain relief achieved by meclofenamate may be due to suppression of myosalpingian and/or myometrial contractions, a process mediated by prostaglandins.
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PMID:Effects of meclofenamate and acetaminophen on abdominal pain following tubal occlusion. 294 86

For unknown reasons, only a few surgeons have become interested in diagnostic and therapeutic laparoscopy. Electronic imaging, the recent adjunct to endoscopy, has enhanced its value. In problematic cases, it is not only important to establish the diagnosis but also to be able to demonstrate the interesting findings during weekly conferences or to reevaluate or recapitulate the findings in the follow-up period. Ascites, pyrexia, abdominal pain with weight loss of unknown origin, a palpable mass, suspected primary or secondary liver tumors, staging, second look, and questionable operability of known primaries are examples of the indications for laparoscopy. If intra-abdominal malignancy is suspected, a computed tomographic (CT) scan or ultrasonic examination is the common current procedure. If liver or parietal peritoneal involvement is present, these costly examinations will not display lesions smaller than 1 cm, whereas they can often be seen during laparoscopy. Repeated CT or ultrasound examinations with guided needle biopsies have a high incidence of noninformative (cytological) specimen retrieval. Laparoscopy, providing a precise, well-aimed biopsy, can be performed under local anesthesia following premedication. It represents an important advantage for high-risk patients because it can be performed with a negligible incidence of complications.
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PMID:Diagnostic and therapeutic laparoscopy. An entity often overlooked by the surgeon. 297 77


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