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

An adverse reaction to the intravenous anaesthetic agent propanidid is described in which the main features were hypotension, facial erythema, and abdominal pain. Changes in serum complement levels and differential white cell counts indicate that this was an immune reaction mediated by the classical complement pathway. The immune reaction apparently involved antibodies other than those of the IgE (reagin) class, and circumstantial evidence suggests that it was specific to propanidid rather than to the entire formulation or to Cremophor EL.
Anaesthesia 1984 May
PMID:Immune reaction to propanidid. 673 77

A series of 101 patients with trauma of the rectum, secondary to homosexual practices, presenting at this hospital and medical center is reviewed. Two patients were injured twice. Thirty-six patients had retained foreign bodies in the rectum, 55 had lacerations of the mucosa, two had disruptions of the anal sphincter and ten had perforations of the rectosigmoid. The majority of retained foreign bodies can be removed on an outpatient basis. If removal is not immediately possible, the patient should be admitted for observation and removal of the foreign body transanally under anesthesia. Routine sigmoidoscopic examination is performed after removal. Removal seldom requires laparotomy. Simple nonbleeding lacerations of the mucosa can be managed on an outpatient basis. Patients with abdominal pain, fever, continued bleeding, large lacerations or tear of the sphincter should be admitted and observed or operated upon, or both, as needed. Serious injuries, secondary to homosexual acts, can and do occur, as evidenced by the mortality reported in this series. Perforations of the rectosigmoid above the peritoneal reflection can be treated by laparotomy, repair of the perforation, removal of gross contamination by irrigation, proximal loop colostomy and appropriate antibiotic therapy. Perforations below the peritoneal reflection are challenging instances which require individualized management.
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PMID:Management of foreign bodies and trauma of the rectum. 683 61

A series in which six cases of ruptured uterus occurred following previous lower segment Caesarean section, out of a total of 222 'trials of scar', is presented, and the literature reviewed in an attempt to clarify the term 'relative contra-indication' as applied to this clinical circumstance. The symptoms and signs of ruptured uterus likely to be blocked by an epidural, i.e. maternal tachycardia, scar tenderness and continuous lower abdominal pain, have been shown to be either unreliable (tachycardia and tenderness) or frequently not to occur at all (pain). When pain does occur it is not necessarily masked by an epidural. It is concluded that previous lower segment Caesarean section is not a contraindication to epidural analgesia in a subsequent labour provided certain conditions are fulfilled.
Anaesthesia 1983 Apr
PMID:Epidural analgesia and previous Caesarean section. 684 63

A comparative study was made regarding the complications of abdominal and vaginal sterilization operations in order to evaluate the efficacy and safety of the 2 procedures. The cases were selected from outpatient departments and family planning clinics of the Patna Medical College (Patna, India) over the 1974-79 period. A preoperative assessment and investigation were performed in all cases. The operations were performed by modified Pomeroy's technique in 300 cases (Group A) by abdominal route and in 300 cases (Group B) by vaginal route. General anesthesia was administered in all cases. Subsequent follow-up was done at intervals of 6 weeks, 3 months, 6 months, 1 year, and up to 5 years. Follow-up attendance was unsatisfactory, but a comparative evaluation of the complications was done in both groups among patients who came for follow-up. Puerperal sterilization cases were excluded from the series. In Group A 149 sterilizations were done with medical termination of pregnancy (MTP) and the remaining were interval sterilizations. In Group B 148 were sterilizations with MTP and the remaining were interval sterilizations. The age varied between 28-42 years. The majority of the patients were more than 4 para in both groups. Pelvic sepsis was more common with vaginal sterilization operations. Complications were as follows in Group A: pyrexia, 30 cases; pain in abdomen, 75; urinary tract infection, 30; sore throat, cough, 60; stitch induration, 90; and wound disruption, 3. For Group B, complications were as follows: pyrexia, 90; pain in abdomen, 30; urinary tract infection, 75; sore throat, cough, 60; tuboovarian mass, 12; wound infection, 45; and persistent temperature rise, 12. The nature of complaints at follow-up for Group A were: leukorrhea, 30; menorrhagia, 60; irregular bleeding, 30; dysmenorrhea, 12; dyspareunia, 9; loss of libido, 9; and incisional hernia, 1. Complaints at follow-up were as follows for Group B: leukorrhea, 45; menorrhagia, 21; irregular bleeding, 60; dysmenorrhea, 75; dyspareunia, 60; loss of libido, 12; abdominal pain, 12; and stress incontinence, 3. In sum, the sterilization operation by abdominal route was much safer compared to the vaginal route.
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PMID:Complications after abdominal and vaginal sterilization operation. 687 69

Inhalation anaesthesia with enflurane was compared with i.v. fentanyl for outpatient termination of pregnancy. Blood loss was greater in the enflurane group with a geometric mean loss of 73.0 ml compared with 43.9 ml in the fentanyl group. There was a greater frequency of nausea nd vomiting in the fentanyl group and no reduction in abdominal pain or need for analgesia after operation. A close relationship was found between blood loss and duration of the procedure but not between blood loss and gestational age or gestational age and anaesthetic time. Either technique is satisfactory for outpatient termination of pregnancy in unpremedicated patients. Despite the greater blood losses with enflurane, it is a safe and reliable method of anaesthesia for this procedure, but the concentration and duration of administration should be kept to a minimum.
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PMID:Anaesthesia for outpatient termination of pregnancy. A comparison of two anaesthetic techniques. 710 36

A multicentered, multinational prospective study of the short-term complications associated with mini-incision for postpartum sterilization performed within 3 days of delivery was undertaken to determine the safety of this approach. Subjects were fully informed, multiparous volunteers with at least 1 living child who had uncomplicated deliveries and were medically fit for operation. Each of the participating centers, Bangkok, Chandigarh, Havana, Manila, Sydney, Santiago, and Singapore, provided premedication and anesthesia according to routine practice. Procedures were carried out via sub- or peri-umbilical incisions of less than 5 cm. Length of incision and duration of operation from incision to skin closure were longer in subjects receiving general anesthesia. Follow-up observations on the 1026 women were made at 8 hours, 1 week, and 6 weeks postoperation. Major complications occurred in 3 subjects; 40 of the 43 subjects with minor complications had wound complications, mostly minor infections. Other minor complications were signs of pelvic inflammatory disease in 2 patients. The majority of subjects with minor complaints, mostly abdominal pain or headache, were in Havana and Bangkok. It is concluded that sterilization in the immediate postpartum period through a mini-incision adjacent to the umbilicus is a safe procedure which can be simply and rapidly performed under regional or local anesthesia. The complication rate for the procedure was low, 4.5% overall, and no cases of thromboembolism were reported.
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PMID:Mini-incision for post-partum sterilization of women: a multicentred, multinational prospective study. 716 Jan 81

DT, a 63-year-old white male with insulin-dependent diabetes mellitus and severe peripheral vascular disease, was admitted with a five-day history of vague abdominal pain and diarrhea. On the day of admission he vomited three times, was noted to have a bloody stool, and came to the emergency room. DT denied hematemesis, fever, or chills. He had bilateral leg amputations and had sustained three myocardial infarctions, the last one 15 months before this admission. He had never experienced symptoms of abdominal angina. Of significance was his history of congestive heart failure, mitral regurgitation, and atrial fibrillation. His medications on admission included digoxin 0.25mg per day, furosemide 40mg per day, and NPH insulin 15 units per day. On admission to the hospital his oral temperature was 38 degrees C, pulse was 90/min, respiratory rate was 24/min, and blood pressure was 134/80mmHg. Abdominal examination revealed a distended abdomen with hypoactive bowel sounds and mild tenderness. Chest x ray revealed cardiomegaly. The electrocardiogram demonstrated atrial fibrillation. A plain film of the abdomen was positive for gallstones and edema of the bowel wall (thumb-printing). Laboratory results included blood urea nitrogen 48mg%, creatinine 1.2mg%, hemoglobin 18g/dl, and hematocrit 52.9%. White blood cell count was 11,900 cells/cc with 33% polymorphonuclear leukocytes, 47% bands, 8% lymphocytes, 11% monocytes, and 1% atypical lymphocytes. The prime considerations for differential diagnosis were mesenteric ischemia and infectious gastroenteritis. While it was appreciated that mesenteric ischemia, if present, might warrant surgical intervention, the risk of anesthesia itself in this patient was felt by his attending physicians to exceed 30%. Furthermore, the clinical findings were only "suggestive" of mesenteric eschemia. They were certainly not "diagnostic." In view of this dilemma, a consultation with the Division of Clinical Decision Making was requested.
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PMID:Abdominal pain, atherosclerosis, and atrial fibrillation. The case for mesenteric ischemia. 716 38

A questionnaire was sent to 260 women who in 1979 had undergone a caesarean section under either epidural or general anaesthesia. Those women who had an epidural for their caesarean section were on average very well informed about the procedure. In contrast, those who had been given a general anaesthetic felt that they had been badly or inadequately informed. Over 90% of the patients of both the epidural and the general anaesthetic groups described the type of anaesthesia which they had received as "very good" to "adequate". In the epidural group, 80% of the patients described the experience of the birth as very intense. Headache, back pain and other complaints such as abdominal pain and wound pain were significantly more frequent in the general anaesthetic as compared to the epidural group. 85.8% of the women given an epidural said that they would choose the same again for a future caesarean, 12.1% would not. Of the group given a general anaesthetic, 29.9% said that in the future they would choose an epidural, and 62.3% that they would prefer to have a general anaesthetic again. The Apgar score at one minute, and the umbilical artery pH values of the newborn of the epidural group were significantly better than those of the general anaesthetic group, whereas at 5 and 10 min the Apgar scores of the babies of both groups showed no differences.
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PMID:[Effectiveness of obstetric epidural analgesia. II. Caesarean section]. 717 53

The organic and psychological problems of patients suffering from chronic abdominal pain are described and three case histories of patients who had undergone multiple surgery for their abdominal pain are presented. All three were treated by lumbar sympathetic lysis, resulting in relief of their pain. The possible reasons for this success are discussed.
Anaesthesia 1981 Mar
PMID:Persistent abdominal pain. Treatment by lumbar sympathetic lysis. 722 20

After briefly describing the history of legal abortion in several West and East European countries, the article examines the Italian law of May 1978. Induced abortion is legal in Italy within the first 90 days of gestation provided a doctor states that pregnancy would endanger the physical or mental wellbeing of the mother, whether the danger is due to economic or social reasons, or when the pregnancy is result of rape or incest, or when there is a chance of malformations in the new born. After 7 days from the first interview with a doctor, the abortion can take place. In the hospital of S. Barbara of Rogliano, Italy, there were 24 requests of abortion in 1978, and 75 in 1979. All women underwent a complete and careful gynecological examination, and were told about the details of the procedure. Anesthesia was in all cases by paracervical block, and the procedure by vacuum aspiration followed by curettage. The majority of patients were in the 1-11 week of gestation, most were either multiparous or nulliparous, and between 18-29. The majority came from districts outside of Rogliano and were married; the number of students and employees taken together exceeded that of housewives. There were 6 cases of metrorrhagia and 3 cases of fever, but no major complications. After the procedure all women were advised to rest, not to engage in sexual activities, and to return to the hospital in case of hemorrhage or abdominal pain. It is hoped that improved contraceptive techniques will reduce the number of requests for legal abortion.
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PMID:[Legal abortion. Preliminary evaluations at the S. Barbara di Rogliano Hospital]. 725 70


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