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Query: UMLS:C0000737 (
abdominal pain
)
31,184
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Segmental infarction of the great omentum is a possible aetiology of
acute abdominal pain
. The diagnosis was difficult before operation and, generally the patient was operated upon with the diagnosis of appendicitis, or less often by laparotomy. The laparoscopy appears to be nowadays the ideal way of diagnosis, as this was the case in two of our patients. The treatment is also possible by laparoscopy (one of our patients). Generally speaking the laparoscopy should be of great help in the diagnosis of some
acute abdominal pain
, and could reduce the number of the so called non specific
abdominal pain
.
...
PMID:[Idiopathic segmental infarction of the great omentum. Value of celioscopy]. 771 Apr 57
Jejunal diverticular (JD) perforation is an uncommon cause of
acute abdominal pain
in the elderly. From 1971 to 1994 we treated 13 such patients, 9 men and 4 women, with a mean age of 68 years. All patients experienced sudden onset of
abdominal pain
, nausea and vomiting, and leukocytosis (range of white blood cell counts, 14,000-21,000). On physical examination, three patients had localized peritonitis, were thought to have appendicitis, and underwent immediate laparotomy and segmental jejunal resection for perforated JD. The remaining 10 patients had abdominal tenderness without peritoneal signs. They were hospitalized and managed expectantly. All experienced worsening signs and symptoms and underwent exploratory laparotomy and resection of the involved jejunal segment 13 hours to 8 days after admission. Although 6 of 13 patients had had JD documented previously, in only 2 patients was perforated JD diagnosed preoperatively. In 8 of 13 patients peritoneal contamination was minimal and was contained within the leaves of the mesentery. Soilage was severe with abscess formation in 5 patients. The longer the delay in operative intervention, the greater the peritoneal soilage. The 3 patients undergoing immediate surgery had minimal contamination. Of the 10 patients initially observed, the mean interval before operation was 74 hours in the 5 patients with severe soilage versus 21 hours in those with minimal contamination. The postoperative course was uneventful in 11 patients. Two patients died. Surgical consultation was delayed (8 days, 12 days) in both patients, who had severe peritoneal contamination and died of sepsis. In conclusion, JD perforation is an uncommon and frequently overlooked cause of
acute abdominal pain
in elderly patients. Timely operative intervention and resection of the involved jejunum are the keys to a successful outcome. Because the presentation and physical findings of perforated JD can be highly variable, a history of preexisting JD should arouse suspicion for JD perforation as the etiology of
acute abdominal pain
in the elderly.
...
PMID:Perforated jejunal diverticula. 854 Jun 41
The paper describes a case of a 40-year old woman who presented with complaints of crampy
abdominal pain
, weight loss, hypermenorrhea, anaemia, fever and peritoneal effusion which were attributed to a large solid pelvic tumour. During the preoperative investigations she had an attack of
acute abdominal pain
with bloody diarrhea assumed to be caused by gastrointestinal infection. The attack ceased quickly after intravenous infusions and antispasmodics were started. Several days later a second even stronger attack of
abdominal pain
with evidence of intestinal obstruction necessitated urgent laparotomy which revealed extensive necrosis of the small intestine with a coexistent large uterine myoma. A resection of the small intestine with a side-to-side anastomosis and hysterectomy with bilateral salpingo-oophorectomy were performed. The patient had an uncomplicated recovery gaining weight but still experienced mild discomfort after meals. The symptoms, the diagnostic difficulties as well as the therapeutic approaches in mesenteric ischaemia are discussed.
...
PMID:[A case of mesenteric thrombosis occurring in a woman with a uterine myoma during her hospital stay]. 865 30
We report the case of a 41-year-old man with
abdominal pain
after envenomization by a puss caterpillar. The patient's medical history and physical examination revealed classic symptoms, leading to the correct diagnosis and appropriate therapy with intravenous calcium gluconate. Although severe, local reactions to puss caterpillar envenomization have been previously described, to our knowledge this is the first report of a patient with severe,
acute abdominal pain
caused by a puss caterpillar's sting.
...
PMID:Sting of the puss caterpillar: an unusual cause of acute abdominal pain. 870 88
Although pneumonia is a known cause of pediatric
abdominal pain
, it may go unrecognized on a patient's initial evaluation. This is particularly true when the infection lies outside of the typically described basilar location. We report three pediatric patients in whom
acute abdominal pain
was the sole or primary manifestation of a nonbasilar pneumonia.
...
PMID:Pneumonia in unexpected locations: an occult cause of pediatric abdominal pain. 874 26
99 patients, 67 of whom were female, with a mean age of 25.5 years, were admitted as emergencies between 1991 and 1992 for
acute abdominal pain
of unknown aetiology. The follow-up, carried out prospectively, was 100% at 1 month, 98% at 6 months, 95% at 1 year, 84% at 2 years. The patients were divided into 3 groups: group I: 42 patients only underwent investigations; group II: 31 underwent laparoscopy, and the appendix was left in place after being considered to be normal by the surgeon; group III: 26 underwent laparoscopic appendicectomy for a histologically normal appendix. For 90% of patients, the painful episode never returned. In the other cases the pain returned within one year, but there was no difference between the three groups (11.2%, 9.6%, 11.5%) (ns). The causes found at the second admission were largely genital, or rare diseases (Crohn, Spiegel hernia). 2 patients were operated for acute appendicitis, not recognized in Group I. In those who had a laparoscopy (Group II and III), the incidence of persistent pain was identical whether the appendix was considered to be normal by the operating surgeon or found to be normal histopathologically. This study suggests that: after admission for
acute abdominal pain
of unknown cause, the incidence of recurrence of pains is of the order of 10% within one year; the investigations carried out during the patient's admission, allowed the exclusion of serious diseases for three years; the risk of missing a true appendicitis is small (2.5%) and has no prognostic significance; the finding of a normal appendix during laparoscopy should not necessarily lead to its removal; one year follow-up is sufficient to assess the outcome of
abdominal pain
of unknown cause.
...
PMID:[What are abdominal painful syndromes of unexplained origin? Prospective study: 99 patients followed for three years]. 876 28
A 25-year-old Japanese woman who had been suffering from systemic lupus erythematosus (SLE) for 12 years was admitted to our hospital with a suspected diagnosis of peritonitis after suddenly developing severe
abdominal pain
and distention which could not be relieved by treatment with anodyne. Noninvasive examinations did not provide enough evidence to rule out acute appendicitis, bowel perforation, or ischemia due to vasculitis. Therefore, in consideration of the severity of her uncontrollable
abdominal pain
, an exploratory laparotomy was performed. The operative findings revealed nonbacterial peritonitis with a large amount of ascites and an edematous small bowel. No perforation of the intestine was found. On post-operative day (POD) 3, the severe
abdominal pain
redeveloped, but responded well to steroid pulse therapy. Based on the operative findings and her clinical course, the most likely diagnosis was thought to be acute lupus peritonitis. It is often difficult to ascertain whether
abdominal pain
in an SLE patients is due to lupus peritonitis or to an underlying cause requiring surgery. Thus, it is essential that continuous and careful assessment of the surgical abdomen is performed when a patient with SLE develops
acute abdominal pain
, and if a surgical condition cannot be ruled out, a laparotomy should be performed without delay.
...
PMID:Lupus peritonitis mimicking acute surgical abdomen in a patient with systemic lupus erythematosus: report of a case. 888 45
A quality audit was performed of the case records of 1313 children admitted with
acute abdominal pain
over a three year period under the care of paediatric surgeons at the Princess Margaret Hospital for Children, Perth. Fifty-four per cent (n = 714) of the patients were discharged without surgical intervention; in this group the most frequent (70%, n = 503) diagnosis was non-specific
abdominal pain
(NSAP). Of those children having surgery, 74% (n = 443) had appendicitis proven on histopathology; the remaining appendices (n = 134) were reported as normal and no other surgical cause for the patients symptoms were identified. Only 3.7% (n = 22) of children having surgery had another surgical cause for their pain. Of this group, 11 had adnexal pathology, eight had complications of a Meckel's diverticulum and three had torsion of the omentum. There were no deaths in this series, and 39 patients (3%) had wound infections. Based on these results, only 35% of children referred to a surgeon with
abdominal pain
will actually require surgical intervention, although as a consequence of concern over clinical status an additional 10% will have a laparotomy with normal findings.
...
PMID:Acute abdominal pain in children: an analysis of admissions over a three year period. 888 58
The purpose of this study was to determine 1) the incidence and magnitude of elevation in admission serum amylase and lipase levels in extrapancreatic etiologies of
acute abdominal pain
, and 2) the test most closely associated with the diagnosis of acute pancreatitis. Serum amylase and lipase levels were obtained in 306 patients admitted for evaluation of
acute abdominal pain
. Patients were categorized by anatomic location of identified pathology. Logistic regression analysis was used to compare the enzyme levels between patient groups and to determine the correlation between elevation in serum amylase and lipase. Twenty-seven (13%) of 208 patients with an extrapancreatic etiology of
acute abdominal pain
demonstrated an elevated admission serum amylase level with a maximum value of 385 units (U)/L (normal range 30-110 U/L). Twenty-six (12.5%) of these 208 patients had an elevated admission serum lipase value with a maximum of 3685 U/L (normal range 5-208 U/L). Of 48 patients with
abdominal pain
resulting from acute pancreatitis, admission serum amylase ranged from 30 to 7680 U/L and lipase ranged from 5 to 90,654 U/L. Both serum amylase and lipase elevations were positively associated with a correct diagnosis of acute pancreatitis (P < 0.001) with diagnostic efficiencies of 91 and 94 per cent, respectively. A close correlation between elevation of admission serum amylase and lipase was observed (r = 0.87) in both extrapancreatic and pancreatic disease processes. Serum amylase and lipase levels may be elevated in nonpancreatic disease processes of the abdomen. Significant elevations (greater than three times upper limit of normal) in either enzyme are uncommon in these disorders. The strong correlation between elevations in the two serum enzymes in both pancreatic and extrapancreatic etiologies of
abdominal pain
makes them redundant measures. Serum lipase is a better test than serum amylase either to exclude or to support a diagnosis of acute pancreatitis.
...
PMID:Serum amylase and lipase in the evaluation of acute abdominal pain. 895 42
Acute abdominal pain
is a frequent diagnostic and therapeutic challenge in hematologic patients. We report on the very rare case of organ endometriosis with acute abdominal symptoms in a 43-year-old female patient with AML-M5, starting 4 days after induction chemotherapy with idarubicin, ara-C, and etoposide. The patient presented with an acute abdomen with clinical findings of acute cholecystitis, subileus, and local pain in the right upper abdomen accompanied by severe diarrhea. Probably due to impaired intestinal resorption, menstrual bleeding occurred despite regular administration of lynestrenol. Ultrasound examination of the abdomen disclosed a tumor with poor echoes in the pouch of Douglas, a subcapsular splenic hemorrhage, and a thickened gallbladder wall with surrounding edema. A cystic adnex tumor was confirmed by endovaginal ultrasound. Based on history and the findings on ultrasound, an endometriosis was diagnosed, and the LHRH agonist (nafarelin) was administered nasally in combination with lynestrenol. Following this medication the
abdominal pain
ceased, supporting the diagnosis of endometriosis. Nasal administration of an LHRH agonist in the following cycles of chemotherapy was effective in preventing further abdominal discomfort and vaginal bleeding. LHRH agonists should be given to patients with known endometriosis before starting myeloablative chemotherapy to prevent painful hemorrhage from endometriosis.
...
PMID:Acute abdomen due to endometriosis as a diagnostic and therapeutic challenge in the treatment of acute myelocytic leukemia. 903 12
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