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

Chronic intermittent abdominal pain in childhood, reported to afflict nine to 12 per cent of all children, is an enigma of such magnitude that more than 30 per cent of these patients reach adulthood with persistent problems and no definitive diagnosis. This report discusses 20 children with such pain (9 girls and 11 boys) in whom routine diagnostic evaluation failed to identify the etiology. Selected special diagnostic studies and considerable suspicion for chronic pancreatitis prompted surgical intervention in three patients. Two were unsuspected and identified at celiotomy as having pancreatitis. The morphine-neostigmine evocative test, modified in some cases to confirm its usefulness, was helpful, accurate, and definitive in all 13 patients on whom it was used. Eighteen patients were confirmed surgically to have pancreatic disease, and two patients are unoperated with continued pancreatic pain. Ductal pathology was believed present in all. Of 18 patients operated, 11 patients are asymptomatic, five patients are improved, and two patients are considered failures 6 months to 10 years following surgery.
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PMID:Chronic relapsing pancreatitis in childhood. 258 Apr 66

The objective of this study was to examine demographic, clinical, and pathologic variables, including Helicobacter pylori infection and malignancy, associated with chronic abdominal pain in a rural Haitian population. One hundred four patients underwent esophagogastroduodenoscopy, with biopsy only in those with gross findings. Associations between demographic, clinical, and pathologic variables were examined using the chi-square test. P values less than or equal to 0.05 were considered statistically significant. The majority (n = 66; 63%) required biopsy. Of these, 62% were positive for H. pylori. The associations between (1) chest complaints and esophageal disease, (2) female gender and benign esophageal disease, and (3) chronic active gastritis and presence of H. pylori were significant. There was one malignancy. H. pylori gastritis was common; malignancy was rare. Demographic and clinical variables poorly predicted pathologic diagnosis, which is consistent with previous studies. Further study is needed to assess the influence of other variables, including the African enigma, on disease progression in this population.
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PMID:Chronic abdominal complaints and Helicobacter pylori in a Haitian population. 1525 72

Wandering spleen, also referred to as 'ptotic spleen', is a rare clinical condition characterized by splenic migration form its normal left hypochondrial position to any other abdominal or pelvic position. Among the multifactorial etiologies proposed, laxity of the spleen's primary supporting ligaments is the most agreed-upon hypothesis. We present one rare case of wandering spleen in an 11-year-old girl who presented with recurrent abdominal pain with no localizing features. Her abdominal examination revealed an intra-abdominal left iliac fossa lump with restricted mobility, which was confirmed as a wandering spleen by abdominal sonography and contrast-enhanced computed tomography. Intraoperatively, an infarcted spleen was encountered with tortuous, elongated, torsional splenic pedicle and a single dense adhesive band with descending colon. Splenectomy was offered to the patient. Post-operatively, the patient is healthy and symptom free at one-year follow-up. The rare clinical diagnosis of this condition, particularly in the paediatric age-group, makes it an enigma for the surgical world.
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PMID:Wandering spleen: a surgical enigma. 2624 Jan 17

Two hundred and fifty years have passed since the birth of Ludwig van Beethoven, and the enigma about his hearing loss and overall health status seems to be not completely solved. However, the admission to the hospital of a 64-year-old woman in 2018 with symptoms extremely similar to those experienced by the great composer may add further evidence to a theory previously underestimated. The health issues of the modern patient were found to be due to chronic lead intoxication. The lead was released during daily cooking using a ceramic-coated frying pan with worn surface that poisoned her breakfast most probably for years. Abdominal pain, asthenia, and hearing loss affecting the high frequencies with a many impact on speech intelligibility tormented the patient, as they had Beethoven. An extensive review of the music and medical literature was performed, as well as re-examination of manuscripts, correspondence, and autopsy reports of the famous composer; and great similarities have been found. The soundness of the most-cited classical theories about Beethoven's hearing loss will be discussed. After close scrutiny of the theories, our analysis points toward a progressive sensorineural hearing loss due to lead intoxication as the most probable cause of not only Beethoven's hypoacusis but his overall health status as well. Laryngoscope, 2020.
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PMID:A Modern Case Sheds Light on a Classical Enigma: Beethoven's Deafness. 3190 78