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

Tuberculous peritonitis is an uncommon disorder and is often not considered on initial evaluation of ascites. A negative 5-TU PPD test, a normal chest roentgenogram, or a low level of ascitic fluid protein may erroneously direct attention away from tuberculosis. Failure to thoroughly evaluate nonmalignant exudative ascites, especially in alcoholics, is a common diagnostic pitfall. TB peritonitis should be considered in the differential diagnosis in every patient who presents with ascites, fever, and abdominal pain, particularly when alcoholism, a lung lesion, weight loss, or cirrhosis is also present. Percutaneous needle biopsy of peritoneum, followed by peritoneoscopy if necessary, may preclude the need for laparotomy. Antituberculous drugs, when conscientiously taken, afford a rapid response with a cure in most patients. Case material on four patients is presented.
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PMID:Tuberculous peritonitis. 51 68

Four patients developed miliary tuberculosis while undergoing chronic hemodialysis. Two patients had diabetes mellitus. Three of the four patients were hemodialyzed 18--24 months prior to the onset of symptoms. Signs and symptoms included prolonged fever, pleural effusion, pericarditis with pericardial effusion, abdominal pain, weight loss, and ascites. All patients were PPD negative and without historical or radiographic evidence of latent tuberculosis. Disseminated tuberculosis was proven at autopsy in three patients. M. tuberculosis was eventually recovered from pleural fluid and urine in the fourth patient. The immune deficiencies of chronic renal failure and diabetes mellitus are suspected predisposing factors to the development of miliary tuberculosis in these patients.
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PMID:Unusual presentation of tuberculosis in chronic hemodialysis patients. 89 Oct 49

The clinical features, radiological and therapeutic response of 46 cases of abdominal tuberculosis (AT) seen at a university hospital are presented. Diagnosis was anatomopathologic in 39 cases (85%) and clinical with response to tuberculostatic in 7 cases (15%). Most of the patients did not have history nor exposition to tuberculosis. Both sexes were similar affected, mean age 43 years old, between 11 and 79. Clinical manifestations were no specific, the most frequent fever (65%), abdominal pain (63%) and constitutional syndrome with asthenia, anorexia and weight loss (63%). Thorax radiograph was normal in 50% and PPD negative in 42%, so in 10% of patients both tests were negative. More than half of the patients had other disease. 82% of patients were cured with tuberculostatic. 18% of patients died. AT seen now is different from classic descriptions. Is not a complication of pulmonary tuberculosis (PT) as it was to be in the past. Thinking in AT only in patients with PT make most patients lead without diagnosis.
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PMID:[Abdominal tuberculosis today. A review of 46 cases]. 163 55

Although conventional wisdom advises removal of the Tenckhoff catheter as part of the therapy for tuberculous peritonitis, there are a few recent reports of cases successfully treated while maintaining the patients on CAPD. We wish to report three cases treated without interrupting CAPD. In two of the patients, cultures were positive for Mycobacterium tuberculosis and in the third case, although the cultures were negative, the patient improved on anti-Tb medications. Smear for AFB was positive in one patient; and two had a positive PPD. All had predominance of lymphocytes and monocytes in effluent. The total WBC count was 160-300 and two patients had fever. All had abdominal pain. One patient was treated with INH and ethambutol; one with INH and rifampin and one (who was suspected of being HIV+) also received pyrazinamide (PZA) until culture was available. Cultures grew in 4-6 weeks. All were started on therapy prior to having the culture results, and all showed clinical improvement within two weeks. One patient had his catheter replaced two months later because of pseudomonas peritonitis, continued on CAPD for an additional five months, then changed to HD because of recurrent bacterial peritonitis. One patient died of complications of diabetic vascular disease three months later with no evidence of peritonitis. One patient has remained on anti-Tb treatment for seven months and is doing well on CAPD.
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PMID:Successful treatment of tuberculous peritonitis while maintaining patient on CAPD. 168 Apr 1

Tuberculosis of the spine or ribs is uncommon, occurring in less than 1% of patients with tuberculosis (TB). 2 women are presented who recently immigrated from Ethiopia and India, respectively. One, aged 55, presented with chest pain, fatigue and several masses under the skin of the scalp. Chest X-ray and CT scan suggested Pancoast tumor, and the lateral parts of the first 2 right ribs were absent. The origin of the patient, clinical findings and positive PPD suggested TB of the ribs and anti-TB therapy resulted in cure. The diagnosis was later confirmed by a positive culture. The other woman, aged 68, presented with fatigue, mild abdominal pain and axillary lymphadenopathy. The PPD was positive and X-ray showed widening of the mediastinum. A caseating granuloma with Langhans epithelioid cells was found in a lymph node. Flaccid paraparesis developed before therapy was started. CT scan showed a typical picture of TB affecting the T3-T6 vertebrae. Drainage of a cold abscess of the spine via the anterior approach was followed by anti-TB therapy. Culture of a biopsied lymph node and of pus obtained at operation confirmed the diagnosis of TB. The patient died 2 months later from gastrointestinal bleeding. Awareness of the unusual presentations of various forms of TB is mandatory in countries with immigration from countries in which TB is still common.
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PMID:[Tuberculosis of the spine and ribs]. 175 49

We present a patient with acute and severe abdominal pain, fever and mild tenderness elicited on deep palpation in the right lower quadrant. X-ray films of the chest and abdomen were normal. The ultrasonographic study, barium enema examination and colonoscopic study avoided a diagnostic laparotomy. A purified protein skin test (PPD) and the cultures on Lowestein medium were negative. The final diagnosis was ulcero-hipertrophic tuberculosis of the ascending colon, and was confirmed by the finding of positive acid fast facilli and granulomas with Langerhans cells in the colonic biopsy material. The colonic lesions disapplared at the end of the antituberculous treatment.
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PMID:[Colonic tuberculosis. Endoscopic diagnosis]. 193 Dec 47

From 1972 to 1989, 20 cases of tuberculous peritonitis were seen in Tokyo Metropolitan Geriatric Hospital. In 13 patients the diagnosis of tuberculous peritonitis was made only at autopsy, which in 7 patients was made during life. Of all 20 cases the mean age was 78 years, with a range of 63 to 96 years. There were no differences in mean ages between autopsied patients and clinically diagnosed patients. There were 11 male and 9 female patients. In autopsied patients 6 were male and 7 were female. Of the clinically diagnosed patients 5 were male and 2 were female. Seven of 13 patients who were diagnosed at autopsy had liver diseases, for example liver fibrosis, liver cirrhosis, hepatocellular carcinoma or chronic hepatitis. In 4 of 7 patients who were diagnosed during life, ileus was also present and their diagnosis of tuberculous peritonitis was made at operation. Only 6 patients had tuberculin test with intermediate strength PPD. There were no positive reactions. In patients who were diagnosed during life, abdominal swelling, anorexia, abdominal pain and fever, the most common clinical manifestations, were seen in 100%, 75%, 50% and 86%, respectively. In contrast, they were seen in 33%, 57%, 0% and 62%, respectively, in autopsied patients. The volume of ascitic fluid varied from zero to 3000 cc. Total white-cell count in the peripheral blood was within or lower than the normal range in 85% of all 20 cases. The lymphocytes count in the peripheral blood was decreased in 95% of all 20 cases. There were no characteristic features in the serum biochemical analysis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Clinical and pathological features of tuberculous peritonitis in the elderly]. 207 56

A 13 year-old girl with Down's syndrome was admitted to our hospital with a very positive reaction to PPD 5TU, abnormal shadow on the chest X-ray films and diarrhea. She suffered from acute enterocolitis one year ago, and then has been complaining of abdominal pain, appetite loss, and weight loss for a year. After admission, she was diagnosed as tuberculous pleuritis and suspected intestinal tuberculosis by laboratory examination. She recovered without sequelae by the combination therapy of SM, INH, and RFP, and was discharged after 5 months. The diagnosis of intestinal tuberculosis was confirmed by Colon Fiberscopy showing ulceration at the ileocecal region and simultaneous biopsy showing granuloma. Surgical treatment was not reserved, because she had no complications namely perforation and fistulization. We estimated that the onset of intestinal tuberculosis coincided with the acute enterocolitis which she had about one year ago. We realized the importance of paying attention to intestinal tuberculosis in the differential diagnosis of enterocolitis, especially regional enteritis. Furthermore, in the therapy of the immunocompromised host including Down's syndrome, we must pay attention to extra-pulmonary tuberculosis. Efficiency of SM for intestinal tuberculosis with complications was confirmed.
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PMID:[A child case of Down's syndrome with intestinal tuberculosis and tuberculous pleuritis]. 253 5

In this retrospective study, clinical presentation of peritoneal tuberculosis in an area with a high prevalence of tuberculosis is discussed. Thirty cases diagnosed in an eight-year period are presented. The disease was 2.3 times more common in females. Eighty per cent of the patients were less than 40 years old. Excluding two cases of long duration (one year and three years), mean duration of the symptoms before admission was 2.3 months. Fever, abdominal pain, swelling and weight loss were the main symptoms. Ascites was clinically detected in 80 per cent of cases. Intermediate strength PPD tuberculin skin test was positive in 61 per cent of cases. In 57.7 per cent there was radiologic evidence of pleuropulmonary disease suggestive of tuberculosis. Fourteen of 15 ascitic fluids examined were exudative in nature with predominance of lymphocytes. In the majority of patients diagnosis was proven with laparotomy and laparoscopy (12 cases in each group). In the remainder, tissue for diagnosis was obtained through blind peritoneal needle biopsy, percutaneous biopsy of liver and peripheral lymph node biopsy (two cases with each method).
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PMID:Tuberculous peritonitis--report of 30 cases and review of the literature. 405 4

A 13-year-old girl was hospitalized for further investigation of abdominal pain and pain on the left side of the chest. Laparoscopy and subsequent laparotomy findings were negative. Chest roentgenograms disclosed subpulmonic fluid, the examination of which exposed a sterile mononuclear exudate. Because of these findings and a positive first-strength PPD tuberculin skin test result, the patient received antituberculosis and steroid therapy for six months with no effect. Exploratory thoracotomy revealed a thymic cyst situated in the left subpulmonic area. Thus another possible origin of subpulmonic effusions should be considered.
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PMID:Thymic cyst manifesting as subpulmonic fluid. 683 Mar 99


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