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

Delayed atrioventricular conduction, as reflected in prolongation of the P-R interval, is commonly found and is a non specific finding in acute rheumatic fever (minor manifestation). Prolongation of atrioventricular conduction may lead to second-degree A-V block, while a complete heart block is a rare event with or without Stokes-Adams attacks. In these cases temporary pace-maker may be usefully employed. Another uncommon symptom of acute rheumatic fever is abdominal pain, which occurs in fewer than 5% of patients, and is usually vague and not acute. An unusual case of onset of rheumatic fever characterized by acute complete heart block and acute abdominal pain simulating appendicitis is reported.
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PMID:[Complete atrioventricular block and acute abdominal pain: initial symptoms in a case of rheumatic fever]. 234 4

Afferent loop obstruction after gastrectomy and Billroth II reconstruction is an uncommon problem. Complete acute obstruction requires emergent laparotomy. However, chronic obstruction may begin insidiously and its symptoms may reflect other gastrointestinal diseases. Two patients are described who developed acute abdominal pain, marked hyperamylasemia, and palpable abdominal masses 5 and 15 years after Billroth II gastrectomy. The masses were initially interpreted as pancreatic pseudocysts. Both patients were found to have chronically obstructed afferent limbs, and in one the obstruction was associated with hundreds of stasis stones within the afferent limb. Surgical decompression was accomplished in each patient. Patients who have undergone Billroth II reconstruction have signs, symptoms, and laboratory findings consistent with acute pancreatitis. A history of previous gastrectomy, recurrent or severe abdominal pain, hyperamylasemia with characteristic tomography, and endoscopic findings will establish the diagnosis and necessitate surgical evaluation and intervention.
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PMID:Afferent loop obstruction presenting as acute pancreatitis and pseudocyst: case reports and review of the literature. 236 Jan 86

Two horses were presented with lethargy, weight loss, anorexia, and swelling of the limbs and ventral body wall. One horse, a 12-month-old American Paso Fino colt, also had acute abdominal pain. The other horse, a seven-month-old Tennessee Walking Horse (TWH) filly passed diarrheic stools during the initial examination. Each horse had low serum protein, neutropenia, and a normal packed cell volume (3.2 g/dl, 1300 cells/ul, and 38%, respectively, for the colt, and 2.4 g/dl, 696 cells/ul, and 44%, respectively for the filly). After intravenously administering plasma, the colt's PCV dropped to 23%, and the filly's dropped to 30%. During exploratory surgery, 3.5 and 2.0 meters of thickened terminal small intestine were removed from the colt and filly respectively, and a jejunocecostomy performed. The results of histologic examination of resected intestine were consistent with a diagnosis of equine granulomatous enteritis (EGE). Both horses showed clinical improvement within two days after surgery. The colt developed a neutrophilia (20,500 cells/ul) within 24 hours of surgery. Serum protein concentrations remained stable and gradually elevated to normal or near normal values of 7.0 g/dl (colt) and 5.8 g/dl (filly) by two weeks. The colt was killed four months after surgery because of signs of abdominal pain. Postmortem examination revealed a small intestinal volvulus associated with an adhesion. The TWH filly remains clinically normal 13 months after surgery.
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PMID:Effect of intestinal resection on two juvenile horses with granulomatous enteritis. 236 25

The purpose of this paper is to study the use of upper gastrointestinal (Gl) fiberoptic endoscopy in children. Two hundred consecutive patients referred to one of the authors were reviewed. The indications for performing upper gastrointestinal endoscopy in these 200 patients were: (1) recurrent abdominal pain (46.5%), (2) persistent vomiting (14.5%), (3) haematemesis (14.5%), (4) acute abdominal pain (13%) and (5) other indications such as foreign body removal, failure to thrive and unexplained chest pain (11.5%). The endoscopy was performed with the Olympus P3 or Olympus XP-10 gastroscopes. The sedation used was a combination of intravenous pethidine (2mg/kg) and diazepam (0.5 mg/kg). Among the patients with recurrent abdominal pain, upper Gl endoscopy showed duodenal ulcer in 7 patients (7.5%), duodenitis in 4 (4.3%), oesophagitis in 4 (4.3%) and gastric ulcer in 2 (2.2%). The rest of the patients were normal (81.7%). With regard to persistent vomiting, 37.9% of the patients showed gastroesophageal reflux and 6.9% had a hiatus hernia. Of 29 patients examined endoscopically for upper Gl bleeding, no focus of bleeding was identified in 27.6%. The remaining 72.4% were bleeding from acute gastric erosion (27.6%), oesophagitis (17.2%), oesophageal varices (13.8%), duodenal ulcer (10.3%) and Mallory-Weiss tear (3.5%). The Majority of the patients with acute abdominal pain were normal endoscopically (61.5%). The two common abnormal findings were acute gastritis (27.0%) and acute duodenitis (11.5%). No major complications were encountered during the procedure in these 200 patients. It was concluded that upper Gl endoscopy is useful for defining upper Gl mucosal pathology. The procedure can be performed safely in children under sedation.
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PMID:Upper gastrointestinal endoscopy in children. 237 74

This report examines the value of laparoscopy as a diagnostic aid to one general surgeon. Seventy-seven consecutive patients who underwent this procedure are reported. In 31 patients, laparoscopy was performed for assessment of the cause of acute abdominal pain. Diagnosis was achieved in 28 patients (90 percent) and laparotomy was avoided in 17 (55 percent). Assessment of chronic abdominal pain in 11 patients yielded a diagnostic accuracy in 9 (82 percent) and laparotomy was avoided in 7 (64 percent). In 11 patients with abdominal trauma, diagnostic accuracy was 91 percent (10 of 11 patients) and laparotomy was not required in 6 (54 percent). In 21 patients with intraabdominal malignancy, 14 (67 percent) were accurately assessed, and in 8 (38 percent) formal exploration was spared. Three patients with obscure causes of ascites and jaundice were all accurately assessed without need for laparotomy. Based on our data, we believe the reports in the literature are reproducible by any abdominal surgeon who uses laparoscopy as a diagnostic aid in their practice.
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PMID:Diagnostic laparoscopy. 252 69

In a survey of emergency admissions to hospital in rural Thailand, acute appendicitis was the commonest cause of acute abdominal pain. Estimates of the incidence of appendicitis, in two series comprising a total of 356 patients, at 3.2 and 3.7 per 10,000 population per year, were relatively high compared with reports from other warm climate countries. In comparison with 1825 cases in studies sponsored by the Organisation Mondiale de Gastroenterologie (OMGE), Thai patients with acute appendicitis were older, presented late and experienced more complications than those in 14 other countries. In Khon Kaen only 2-3% of the cases were children aged 0-9 years, compared with 9-26% in the OMGE series. In patients admitted to hospital with acute abdominal pain in Thailand, acute appendicitis was diagnosed more often than non-specific abdominal pain. The converse was true in the OMGE series. This may reflect the longer distances travelled to hospital by many patients and delays between onset of symptoms and admission to hospital. Acute appendicitis was the commonest definitive diagnosis in both series. This survey indicates that relatively high rates of acute appendicitis may occur in populations eating traditional diets. The results are consistent with the recently described hypothesis of an infective aetiology and increases in appendicitis rates may be expected in people born since the introduction of improvements in environmental sanitation. Further studies are needed to examine trends in the incidence of appendicitis in populations eating traditional diets with both high and low fibre content and to investigate the significance of changing social and environmental factors.
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PMID:Acute abdominal pain and appendicitis in north east Thailand. 258 11

An acute abdominal pain program run on a microcomputer is described and the experiences tabulated for a series of 194 patients seen in a general hospital setting. The initial diagnostic accuracy of the program compared favorably with that of attending physicians and house staff, and suggests that improvements in the program can lead to a more effective and more accurate abdominal pain program. The possibilities for developing other programs, particularly chest pain, fever, and other global categories, are obvious. We are presently working on a chest pain program and a diagnostic strategy program. Based on the results reported here, we believe that several factors could improve program accuracy. For example, with additional clinical studies and refinement of the program structure, with more expert knowledge, and with further algorithmic development, the program could be made to outperform the average clinician and possibly approach the level of true clinical experts in abdominal pain diagnosis by mimicking their analysis. Indeed, since a program of this type is capable of incorporating the expertise of many different clinicians, it has the potential of outperforming any given expert in specific cases.
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PMID:Computer-assisted diagnosis of acute abdominal pain. 264 83

Most patients presenting to the emergency department with acute abdominal pain suffer from disorders requiring other than surgical intervention. Unnecessary morbidity may be avoided through understanding the anatomic and physiologic variables involved in producing abdominal pain. Table 1 lists conditions that may simulate an acute surgical abdomen. Selected disorders were discussed.
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PMID:Nonsurgical and extraperitoneal causes of abdominal pain. 266 65

Internal hernias are rarely diagnosed. Most of the times they are found at laparotomy when complications and their symptoms (for instance palpable tumour, abdominal pain, vomiting and ileus) require surgical treatment. We present a case of an eleven-year-old boy who was admitted to our hospital because of acute abdominal pain. Appendectomy brought only temporary relief of pain. Subsequent laparotomy yielded the diagnosis of left-sided paraduodenal hernia.
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PMID:[Acute abdomen caused by paraduodenal hernia]. 275 Mar 42

Acute abdominal pain (AAP) is one of the most frequent causes of admission to an emergency department of a childrens' hospital. The diagnosis viewed with the most apprehension is acute appendicitis. We present the results of a prospective study on the evaluation of the clinical and paraclinical symptoms generally observed in an AAP, and discuss the benefit of a diagnostic score for acute appendicitis. Twenty-five different diagnoses were observed, the 5 most frequent being: "non specific" (34.2%), constipation (16%), otorhinolaryngological infection (11.6%), gastroenteritis (10.7%) and acute appendicitis (10.5%). The study of 12 symptoms showed an elevated sensitivity for each one (92-50%), but a low positive predictive value (72-12%). Rigid adhesion to a diagnostic score would have led to unnecessary medical examination.
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PMID:[Prospective evaluation of admission for acute abdominal pain in children]. 279 8


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