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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 of mesenteric arteritis complicating the post-operative coarctectomy in a 5 day old infant is described. This case was of interest due to diagnostic difficulties and the fatal outcome. In order to avoid the disastrous consequences of this syndrome, the following symptoms including fever, intestinal bleeding, ileus, nausea, vomiting, leucocytosis, hypertension or
abdominal pain
should alert the physicians and treatment should start without delay.
J
Cardiovasc
Surg (Torino)
PMID:Postcoarctectomy mesenteric arteritis presenting as neonatal appendicitis. 51 13
The authors here refer about the clinical case of a patient suffering from cirrhosis and hyperdynamic circulatory state due to a giantism of the hepatic artery. The surgical ligature of the main hepatic artery determined the complete regression of the
abdominal pain
and melena: the high output cardiac failure also disappeared with surgical correction.
J
Cardiovasc
Surg (Torino)
PMID:Cirrhosis and hyperdynamic circulatory state due to a dysplasic giantism of the hepatic artery. 93 79
From 1965 to 1973, 7 patients with severe chronic mesenteric vascular insufficiency have been successfully operated upon.
Abdominal pain
, weight loss and epigastric murmur were the most significant symptoms and signs in these diffusely atheromatous patients. Aortography with exposure in the lateral projection was essential for diagnosis and operative planning. Although two and often all three main splanchnic arteries were involved, revasculariztion of only the superior mesenteric artery restored normal hemodynamics. There was no operative mortality. Weight gain was dramatic and post-prandial pain disappeared in all patients. One patient diedone year and one half after the operation from an acute cerebro-vascular accidnet. Our surgical experience in this field, although small, is very gratifying and rewarding.
J
Cardiovasc
Surg (Torino)
PMID:Revascularization of the superior mesenteric artery. 119 39
The dangers of any abdominal aortic aneurysm are discussed, and the disastrous combination of an aneurysm and
abdominal pain
emphasised. These anerysms can be divided into 4 groups. The presentation and operative mortality for each group is discussed, as is the long term survival, state of the peripheral circulation and general health after operation. How results can be improved is considered. It is concluded that all such aneyrysms should be operated upon because of the good immediate and long term results in comparison with those not operated upon.
J
Cardiovasc
Surg (Torino)
PMID:Abdominal aortic aneurysms. 124 5
We analyzed our surgical experience in 20 patients who underwent revascularization procedures for symptomatic chronic intestinal ischemia caused by atherosclerosis. The group comprised 17 women and 3 men, with an age range of 25 to 71 years (mean 58.6 years). Sixteen patients had postprandial
abdominal pain
, and 4 had pain not related to eating. The average weight loss was 23.8 lb. Malabsorption and diarrhea were present in 8 patients. The duration of the symptoms was from 4 to 46 months (mean 13.4 months). One patient presented with acute intestinal ischemia following balloon angioplasty reocclusion of a stenotic celiac artery, and 3 underwent surgery for stenosis of a previously placed graft. Five patients had single mesenteric artery involvement, 10 had double-artery involvement, and 5 had significant occlusion in all 3 mesenteric arteries. The major arteries were revascularized whenever technically possible; therefore, 36 arteries were revascularized in 20 patients. Bypass grafts were done in 27 vessels, reimplantation in 7, and endarterectomy with patch angioplasty in 2. The saphenous vein was used in 12 vessels, polytetrafluoroethylene grafts in 8, dacron in 6, and inferior mesenteric vein in 1. The type of revascularization or graft utilized did not affect long-term patency. Two patients had early graft thrombosis and required intestinal resection. All patients survived the operation. At a mean follow-up of 36 months, all 20 patients were alive and asymptomatic with regard to their abdominal complaint. Ten patients (50%) underwent postoperative abdominal angiography; all the grafts were patent.(ABSTRACT TRUNCATED AT 250 WORDS)
J
Cardiovasc
Surg (Torino)
PMID:Long-term results of the surgical management of symptomatic chronic intestinal ischemia. 128 11
We report the second case of a primary aortoenteric fistula resulting from septic aortitis with a contained aortic leak into the retroperitoneum and finally erosion into the duodenum. An emergency laparotomy revealed a fistula between the third part of the duodenum and a decompressed sac (false aneurysm) arising from a nonaneurysmal, grossly infected pararenal aorta. The purpose of this report is to present this rare case in detail and to review primary aortoenteric fistulas reported in the English language literature. Most fistulas form in association with an abdominal aortic aneurysm and rarely are due to infection. Only 6% of patients presented with the classic triad of
abdominal pain
, a palpable mass, and gastrointestinal bleeding. Although 29% of patients presented with massive hemorrhage, adequate time usually existed for surgical treatment of these complications. A patient with ill-defined
abdominal pain
and fever who suddenly develops a palpable abdominal mass should have an emergency ultrasound or CT scan to exclude the possibility of an infected aortic aneurysm or a contained rupture of an infected nonaneurysmal aorta. If the symptoms are associated with bleeding and the patient is hemodynamically stable, emergent endoscopy should also be performed. If a primary aortoenteric fistula or an aortic pseudoaneurysm is confirmed, emergent surgery should be undertaken to avoid rupture into the bowel or retroperitoneum.
J
Cardiovasc
Surg (Torino)
PMID:Primary aortoduodenal fistula due to septic aortitis. 157 77
A total of 555 hypertensive patients took part in a 2-year multicenter, open-label study to determine the efficacy, tolerance, and safety of long-term therapy with ramipril. In the beginning, all patients were to receive 5 mg of ramipril/day. The dosage was then adjusted in accordance with response to treatment and ranged from 1.25-20 mg of ramipril daily. Of these patients, 129 also received 25 mg of hydrochlorothiazide daily at some point during the trial. To evaluate whether tolerance to ramipril developed during long-term treatment, a subgroup of 202 patients was analyzed for efficacy maintenance. Prior to enrolling in the 2-year study, these patients had received ramipril monotherapy in a short-term, double-blind study and had been classified as responders, i.e., their diastolic blood pressure had been maintained at less than or equal to 90 mm Hg. At the end of 104 weeks of treatment, 45.9% of patients were on 2.5 mg of ramipril alone and 43.6% were on 5 mg of ramipril alone. Only four patients required the addition of 25 mg of hydrochlorothiazide. No clinically important changes occurred, and kidney function was well maintained. The most frequently reported adverse events excluding intercurrent illnesses were dizziness/vertigo (6%), asthenia (4%), nausea (3%), headache (2%), and
abdominal pain
, gastrointestinal disorder, rash, and increased cough (1% each). Ramipril was safe, effective, and well tolerated in the long-term treatment of patients with mild-to-moderate essential hypertension.
J
Cardiovasc
Pharmacol 1991
PMID:Antihypertensive efficacy, tolerance, and safety of long-term treatment with ramipril in patients with mild-to-moderate essential hypertension. 172 24
Mesenteric ischemia associated with carcinoid tumors often presents with nonspecific
abdominal pain
and is usually due to mesenteric branch artery occlusion caused by elastic vascular sclerosis. Mesenteric ischemia was defined by the operative findings of cyanosis or infarction. Eleven patients with intraabdominal metastatic carcinoid tumor were evaluated by angiography. Angiographic narrowing and occlusion of multiple peripheral jejunal and ileal intramesenteric branch arteries was present in 3 patients with mesenteric ischemia, but also occurred in 5 of 8 patients without mesenteric ischemia. Other angiographic abnormalities included staining of the primary tumor (5) or metastases (6), tenting of small mesenteric vessels (5), and occlusion of draining mesenteric veins (2). We conclude that in patients with midgut carcinoid tumors, angiographic narrowing and occlusion of peripheral mesenteric arteries most likely represents elastic vascular sclerosis, is indicative of mesenteric invasion of tumor, but correlates poorly with the presence of ischemia in the subtended bowel. Alternatively, a normal selective arteriogram should exclude mesenteric ischemia as the cause of abnormal pain.
Cardiovasc
Intervent Radiol
PMID:Limitations of angiography for mesenteric ischemia caused by midgut carcinoid tumors. 250 47
Acidosis in gastric mucosa (pHi less than 7.32) was evaluated as a diagnostic test for gastric ischemia, using 80 asymptomatic subjects as controls. Mucosal acidosis was found in 6 patients with
abdominal pain
and 1 with gastrointestinal bleeding. Three had occlusive disease of 2 or more visceral arteries, 3 had occlusive disease of the celiac axis alone, and 1 had an occluded portal vein. One patient had infarcted gut. The abnormal pHi (7.10 +/- 0.11, mean +/- SD) in those with pain was returned to normal levels (7.43 +/- 0.08, p = 0.0003) and the symptoms relieved by revascularization. The abnormal pHi (6.84 +/- .04) in the patient who bled was restored to normal levels (7.48 +/- .03, t = 9.69, p less than .0001) and the bleeding stopped by a central splenorenal shunt. Measurements of pHi in gastrointestinal mucosa may be used as an objective test for evaluating patients suspected of having chronic gastrointestinal ischemia.
J
Cardiovasc
Surg (Torino)
PMID:Chronic gastric ischemia. A cause of abdominal pain or bleeding identified from the presence of gastric mucosal acidosis. 280 10
Presentation of aortic dissection (AD) typically includes chest and/or
abdominal pain
. Gastrointestinal (GI) symptoms other than
abdominal pain
are uncommon. Two patients with AD are described in whom the dominant presenting symptom was GI hemorrhage. Mesenteric infarction complicated acute Type I dissection in one patient whose clinical manifestations simulated ulcerative colitis. In the other patient an old, small asymptomatic Type III AD resulted in a false aneurysm in the retroperitoneum which ruptured into the duodenum. In the latter case an antemortem diagnosis was not made as angiography was limited to the visceral arteries and the abdominal aorta without appreciation of the significance of a focal compression of the abdominal aorta. The possibility of AD thus should also be considered in the evaluation of a patient with acute GI bleeding.
Cardiovasc
Intervent Radiol 1986
PMID:Aortic dissection masquerading as gastrointestinal disease. 308 40
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