Gene/Protein Disease Symptom Drug Enzyme Compound
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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 is presented of a 29-year old woman who developed sudden onset of abdominal pain, vomiting, near syncope, abdominal tenderness, profound hypotension, and a late menstrual period. The patient was in good health and her only medication was zomepirac for musculoskeletal discomfort. An exploratory mini-laparotomy was performed for the suspicion of a ruptured ectopic pregnancy, but no evidence of hemoperitoneum or of ectopic pregnancy was found. A subsequent pregnancy test was negative, and the episode was attributed to a zomepirac reaction. A review of zomepirac and zomepirac reactions is included.
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PMID:A zomepirac reaction mimicking ectopic pregnancy. 673 36

From college data on 50,000 male former students, the records of 126 men who died of pancreatic cancer in a 16-50 yr follow-up period were compared with those of 504 surviving classmates with respect to physical and social characteristics. Return mail questionnaires received from 30,000 surviving alumni in 1962 or 1966 also were reviewed for characteristics that might predict altered risk of pancreatic cancer. Strong positive associations were found for cigarette smoking as reported both during college (p less than 0.001) and at time of questionnaire return (p = 0.03). Smoking 10 or more cigarettes per day during college corresponded to a relative risk of 2.6 with 95% confidence limits 1.5 to 4.6, and a positive smoking history at questionnaire return yielded a relative risk of 2.4 (1.1-5.1). No association was found for collegiate coffee drinking, either before or after adjustment for cigarette smoking. The relative risk for coffee drinking adjusted for smoking was 1.1 (0.7-1.8). In contrast, collegiate tea consumption was associated with a reduction in pancreatic cancer risk. The relative risk for tea drinking adjusted for smoking was 0.5 (0.3-0.9). Men who at college physical examination complained of occasional abdominal pain or discomfort had increased relative risk of pancreatic cancer (3.1 : 1.1-9.0) in the follow-up period.
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PMID:Early precursors of pancreatic cancer in college men. 682 89

A case report of a rather uncommon and serious IUD complication, i.e., the occurrence of massive hemoperitoneum as a result of partial perforation of the uterus by a Lippes Loop IUD, is reported. A 33-year old woman, gravida 4, para 4, was admitted to an Israeli hospital in satisfactory general condition because of diffuse lower abdominal pain accompanied by vaginal staining. Past history revealed no severe previous illness. The woman's periods were regular with the last menstrual period occurring 25 days prior to admission. A Lippes Loop IUD had been inserted 1 year earlier but had caused no discomfort or side effects. On examination the lower abdomen was tender but no rebound tenderness was elicited. Pelvic examination revealed a markedly tender uterus and adnexa. No masses were palpated. Slight intraperitoneal bleeding was suspected, possibly because of ectopic pregnancy or bleeding corpus luteum. The IUD was removed by pulling on the strings which were visible. The procedure was relatively easy but caused marked pain to the patient. Several hours later she complained of diffuse abdominal pain and on palpation the entire abdomen was very tender and patulous. Her condition deteriorated rapidly; she was in shock. An emergency laparotomy was performed. On opening the peritoneal cavity, a large amount of 2000 ml fresh blood and blood clots was observed. The adnexa were found to be normal. On further exploration, a tear of approximately 15 mm was located in the anterior wall of the uterus below the fundus, with active bleeding from a tiny blood vessel. The tear was repaired. The postoperative course was uneventful. The case described seems to represent an instance of embedding of an IUD. Whether complete perforation occurred during intercourse or upon removal is unclear. It is assumed that the IUD in this case was a type 1-2 perforation, i.e., part in the uterine cavity and part in the myometrium, with a degree of variation of the major portion being in the uterine cavity and only a small part in myometrium since insertion or some time following it, with a different degree of the variety, or the IUD only slightly in the uterine cavity with a large degree of myometrial perforation after removal. It is suggested that if a problem is encountered during IUD removal and transmigration of an IUD is suspected, no attempts should be made to remove it per vagina even if the strings are palpable. Under these circumstances, the type and degree of perforation should be diagnosed and its removal by laparotomy or laparoscopy must be considered.
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PMID:Massive hemoperitoneum due to IUD. 683 47

Intestinal obstruction is a common and distressing complication for patients with advanced abdominal or pelvic cancer. Palliative surgery has an inevitable high mortality and morbidity rate in these patients who are often very ill. Conservative treatment, using intravenous fluids and nasogastric suction, has not been shown to cause resolution of the obstruction and it involves hospitalisation, immobility and discomfort. Pharmacological treatment, using drugs to control the symptoms of colic, continuous abdominal pain and vomiting, is effective in the majority of patients. They can therefore be cared for at home or in a hospice. A small group of patients, mainly with high obstruction, will benefit from a nasogastric tube or venting gastrostomy and fluids can be given, if needed, by intravenous or subcutaneous infusion.
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PMID:Management of intestinal obstruction in patients with advanced cancer. 752 7

Adequate measures of diarrheal disease are important to assess severity for clinical use and outcomes research. We developed a questionnaire to assess diarrhea severity and complications, and administered it to 205 HIV positive patients with diarrhea, fever, or weight loss. Noteworthy variations in stool form were reported by individuals and across subjects. Self-reported diarrhea correlated with the occurrence of any stool pictured without form. However, verbal descriptors "loose" and "semiformed" had little value in assessment of diarrheal disease. Both verbal and pictorial stool descriptors correlated well with diarrhea complications (pain, urgency, tenesmus, incontinence, and nocturnal diarrhea). By factor analysis, discomfort and nondiscomfort diarrhea complications loaded on different factors, consistent with clinical experience that discomfort is a distinct problem in diarrheal disease. In summary we have developed an instrument to precisely characterize diarrhea severity that correlates well with clinically important events such as incontinence and abdominal pain.
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PMID:Validation of a new measure of diarrhea. 755 36

In patients who present with chronic unexplained upper abdominal pain or discomfort (functional dyspepsia), therapy should ideally be targeted on correcting the individual's disturbed pathophysiology. Here, putative mechanisms implicated in functional dyspepsia and potential approaches to therapy are critically reviewed in order to determine if targeting treatment is of value. Pharmacological therapies reviewed include those that aim to correct disordered gastric emptying (e.g. cisapride, dopaminergic receptor antagonists, macrolides), reduce visceral hypersensitivity (e.g. somatostatin analogues, cholecystokinin antagonists, opioid agonists, serotonin type 3 receptor antagonists), reduce gastric acid secretion (e.g. H2-blockers, acid pump inhibitors), cure Helicobacter pylori infection, enhance muscosal defence (e.g. sucralfate, bismuth) or modify central nervous system processes. It is concluded that the imperfectly understood pathophysiology of functional dyspepsia contributes to the paucity of established efficacious therapies.
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PMID:Review article: functional dyspepsia--should treatment be targeted on disturbed physiology? 760 50

Ambulatory laparoscopic cholecystectomy was attempted using a new anaesthetic regimen in 50 patients. 46 patients were discharged 3-5 hours after operation, four were admitted to and remained in hospital for 1-5 days, one for psychosocial reasons, one because of emesis and two because of extended surgery. 45 of 46 ambulatory patients were generally satisfied after having experienced ambulatory cholecystectomy. Postoperative pain and nausea were moderate. Only 24% needed parenteral opioids postoperatively, and only 30% needed anti-emetic treatment. One woman suffered unacceptable pain and discomfort during the first two days at home, and would not prefer to have ambulatory treatment (questionnaire). Four patients were readmitted. Two had a forgotten stone in the common bile duct and underwent ERCP to extract the stone, without further complications. The third had a clip occluding the common bile duct. She was reoperated on in order to remove the clip and insert a T-tube in the common bile duct. Finally one woman was readmitted because of abdominal pain and vomiting, of which we never found the cause. She recovered spontaneously. Even though serious complications associated with biliary surgery were unavoidable in this ambulatory series, we have documented that patients can be operated on safely in this way. Most patients were very content, and experienced much less postoperative discomfort than they had expected.
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PMID:[Laparoscopic cholecystectomy as ambulatory surgery. Safety requirements, benefit potential and patient satisfaction]. 765 19

Seven cases of primary parovarian borderline tumors are presented, Comprising 1.6% of 451 cases of parovarian cysts treated. The age range of the 7 cases was from 16 to 60, with a mean value of 37 years. Abdominal mass, lower abdominal pain or discomfort were chief clinical complaints. In one case, because of amenorrhea of 2 months' duration, the preoperative diagnosis was mistaken to be extra-uterine pregnancy. Surgical examination revealed normal appearance of ovaries and fallopian tubes. Smooth-surfaced cystic masses arising from the broad ligaments were found in all of the 7 cases, their size ranged from 3cm x 2cm x 1.5cm to 8cm x 8cm x 7cm. Internal papillary projections single or multiple, and clear serous fluid were seen in all of the 7 cystic specimens. Microscopically the cyst wall and papillary projections were lined with stratified cuboid or columnae epithelium. Abundant and complicated ramifications of the projections were seen. The nuclei showed slight to moderate metaplasia; mitoses were rare. 6 of the cases originated from paramesonephros and 1 ease was of mesonephric origin. The seven patients were living and well during a postoperative follow-up period of 12 months to 11 years. Literature review on primary parovarian borderline tumors, their clinical presentation, pathological characteristics, therapy and prognosis are presented and discussed.
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PMID:[Clinical analysis of 7 cases of parovarian borderline tumors]. 771 77

We sought to prospectively characterize and compare the symptoms of children > or = 5 years of age with recurrent abdominal pain to previously established criteria for irritable bowel syndrome (IBS) in adults. For all eligible subjects, a detailed questionnaire concerning characteristics of abdominal pain and defecatory pattern was completed at presentation. In addition, a battery of screening tests was performed and additional evaluation was done at the discretion of their physician. In all, 227 subjects fulfilled the entrance criteria, but 56 were subsequently excluded because of diagnoses of inflammatory bowel disease (nine cases), lactose malabsorption (46 cases), or celiac disease (one case). Of the remaining 171 patients, 117 had IBS symptoms. In the IBS subjects, lower abdominal discomfort (p < 0.001), cramping pain (p < 0.0009), and increased flatus (p < 0.0003) were more common, whereas dyspeptic symptoms such as epigastric discomfort (p < 0.003), pain radiating to the chest (p < 0.009), and regurgitation (p < 0.02) were more common in the non-IBS subjects. Our study not only confirms the clinical heterogeneity of children with recurrent abdominal pain but also concomitantly demonstrates that most children with this disorder have symptoms that fulfill the standardized criteria for IBS in adults. The identification of subgroups of children with recurrent abdominal pain can provide a framework for the diagnosis of functional bowel disease as well as establish the need for invasive and expensive tests.
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PMID:Characterization of symptoms in children with recurrent abdominal pain: resemblance to irritable bowel syndrome. 913 90

Functional dyspepsia is defined as persistent or recurrent upper abdominal pain or discomfort not explained by structural or biochemical abnormalities. In about half of the patients who present to their practitioner with chronic dyspepsia, no underlying disease is established after clinical investigation. Many clinical trials have been performed to demonstrate a certain relationship between functional dyspepsia and several pathogenic mechanisms like dysmotility, Helicobacter pylori infection, acid output and hypersensitivity to distension. Unfortunately, the conclusions of those studies are conflicting. Short-term follow-up, lack of consensus about diagnostic criteria for functional dyspepsia and unvalidated symptom measures make it difficult to interpret their results.
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PMID:Functional dyspepsia. 776 Sep 72


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