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

Perinephric abscess commonly arises from rupture of an intrarenal abscess into the perinephric space. It rarely results from gastrointestinal pathology. We report two pediatric patients with retrocecal appendicitis that presented with perinephric abscess. A 3-year-old girl presented with high fever and right flank pain for more than 1 week. Ultrasonography showed a right perinephric fluid collection with normal renal parenchyma and collecting system. A perinephric abscess extending from a ruptured retrocecal appendix was diagnosed by abdominal computed tomographic (CT) scan. Her hospital course was complicated with empyema, peritonitis, and pericardial effusion. A 6-year-old girl had lower abdominal pain for 3 days and high fever on the day of admission. Ultrasonography showed a right perinephric abscess with a normal renal contour and a fecalith in the enlarged appendix in the right lower quadrant of the abdomen. Appendectomy and drainage of the perinephric abscess were performed in both cases. We suggest that a ruptured retrocecal appendix must be considered in cases of perinephric abscess, especially in patients with gas bubbles in the abscess and a normal urogenital appearance. Ultrasonography and abdominal CT scan are the preferred diagnostic tools. Prolonged antibiotics and drainage of the abscess are mandatory to decrease morbidity and mortality.
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PMID:Right perinephric abscess: a rare presentation of ruptured retrocecal appendicitis. 1195 55

A 3-year-old boy presented at the Taiwan Adventist Hospital in Taipei with nocturnal epigastric pain and constipation. Abdominal X-ray showed colonic faecal impaction. Abdominal sonography showed gastric stasis with thickened pyloric wall and dilated rectosigmoid colons. The mouth-to-anus transit time (MATT) was prolonged. Endoscopy showed pale gastric mucosa, atony of pylorus and widening of the duodenal bulb. Three weeks after the onset of abdominal pain, he developed urinary incontinence and rapidly deteriorating paraplegia of lower limbs. Magnetic resonance imaging (MRI) showed an extradural intraspinal mass of T5-T8 and a soft tissue mass in the right superior mediastinum. After a laminectomy and tumour excision, the patient's symptoms improved quickly. The pathology revealed Burkitt's lymphoma. This is the first report of nocturnal abdominal pain and constipation as the initial manifestation of spinal Burkitt's lymphoma.
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PMID:Spinal Burkitt's lymphoma manifesting as nocturnal abdominal pain and constipation: a case report. 1456 38

Laparoscopic adjustable gastric banding (LAGB) is a widely performed surgical procedure for morbid obesity. The application of this mini-invasive approach has given the benefits of shorter hospital stay, less postoperative pain and quicker functional recovery. LAGB complications are related either to the access-port, such as port-site infection or tubing disconnection, or to the band, such as band slippage, pouch dilatation, or intragastric migration. We report a case of recurrent small bowel obstruction caused by the connecting tube around a jejunal loop, in a woman who had under-gone LAGB 3 years before. The diagnosis was difficult to establish because the clinical history and examination were non-specific. A 3-dimensional CT scan was needed to explain the cause of the recurrent abdominal pain, and the small bowel loop was freed from the connecting tube at laparoscopy.
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PMID:An unusual complication of gastric banding: recurrent small bowel obstruction caused by the connecting tube. 1683 99

A 3-year-old male was referred because of fever, abdominal pain, and enlarged abdomen. Magnetic resonance imaging showed a very large lobulated mass involving predominantly the right lobe of liver. Tumor histology was consistent with rhabdoid tumor of the liver. The patient received 3 cycles of chemotherapy consisting of ifosfamide, carboplatin, and etoposide alternating with vincristine, adriamycin, and cyclophosphamide, at 3-week intervals. Follow-up magnetic resonance imaging revealed approximately 84% decrease in size of tumor after 2 cycles of chemotherapy. Patient underwent liver transplantation, as the tumor was unresectable. Six weeks posttransplant, the patient received 4 more cycles of chemotherapy. The patient is free of disease at evaluation 3 years posttransplant.
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PMID:Successful management of rhabdoid tumor of the liver. 1755 3

Despite the accumulation of efficacy data for cognitive-behavioral treatment of Irritable Bowel Syndrome (IBS), efforts to investigate methods for increasing access to psychological treatments are in their infancy. The current study examined the efficacy of self-administered treatment in comparison to a wait list control. Twenty-eight participants monitored gastrointestinal (GI) symptoms and completed measures of quality of life (QOL) and psychological distress prior to randomized assignment to self-help treatment or wait list. Wait listed participants later received treatment. A 3 month post-treatment follow-up was included. Seven participants completed immediate treatment; nine the wait list. The self-help treatment significantly decreased composite GI symptom scores in comparison to the wait list, but did not lead to significant improvements in QOL or distress. In the entire treated sample, including wait list crossovers, analyses showed significant improvement in abdominal pain, average GI symptoms, and perceived health and well-being. Interpretation of these results should be considered in the context of several limitations, including small sample size, brief baseline symptom monitoring, and high drop out rate. Despite these limitations, this study is an important first step in empirically validating low-cost, self-administered treatments as a first line psychological intervention for IBS.
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PMID:Preliminary study of a self-administered treatment for irritable bowel syndrome: comparison to a wait list control group. 1756 25

A 3-year-old girl was admitted to hospital with complaints of severe upper abdominal pain and vomiting. On admission, a board-like rigidity in the right hypochondrium was noted, along with a high white blood cell count and a high C-reactive protein value. Abdominal ultrasonography (US) revealed a left-sided enlarged gallbladder with a thickened wall, without gallstones. Contrast-enhanced computed tomography (CT) demonstrated an enlarged gallbladder without enhancement effects and a cystic duct located on the right side of the gallbladder. The patient underwent an emergency operation following a diagnosis of torsion of the gallbladder. The gallbladder appeared gangrenous, and 180 degrees clockwise torsion was found at the neck of the gallbladder. The gallbladder was straightened and then removed without difficulty because there was only slight inflammation around Calot's triangle and the gallbladder was not fixed to the liver. Histopathological examination revealed an acute bleeding infarction of the gallbladder. The patient was discharged on the ninth day after surgery, without any complications. The present case suggested that abdominal US and contrast-enhanced CT examinations are helpful in making a correct diagnosis of torsion of the gallbladder even in an infant; in the event of this diagnosis, prompt cholecystectomy is necessary.
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PMID:Torsion of the gallbladder in a 3-year-old infant. 1916 13

A 3-year old male presented with complaints of pruritus, abdominal pain for 3 weeks and jaundice. Stools were acholic. There was jaundice, liver palpable 3 cm below right costal margin, no ascites or palpable masses. Serology revealed albumin 2.9 g/dl; ammonia of 31 mmol/l; elevated conjugated bilirubin, GGT, ALT, AST and alkaline phosphatase; alpha fetoprotein 1.3 ngm/ml; BhCG 9.1 IU/; PT 12.3 secs, INR 0.9; negative hepatitis A,B,C serology. CT scan showed a non-calcified heterogeneously enhancing mass centered at the liver hilum. MRCP showed a large heterogeneously enhancing, partially solid mass in the region of the porta hepatic. Liver biopsy revealed patternless proliferation of polymorphic oval to spindled shaped neoplastic cells. There was bile ducts distortion. Immunohistochemistry revealed positivity for vimentin, desmin.These findings were diagnostic for biliary rhabdomyosarcoma.There was no evidence of metastasis. Chemotherapy was initiated. Repeat imaging 6 months after initiation of treatment showed improvement in the degree of intrahepatic ductal dilatation and decrease in tumor bulk size. Rhabdomyosarcoma is the most common malignant tumor of the biliary tree in childhood. It is difficult to diagnose and delayed diagnosis influences the prognosis.
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PMID:Biliary rhabdomyoscarcoma mimicking choledochal cyst. 1933 43

We herein report a 3-year-old male demonstrating invasive cholangiocarcinoma (CC) associated with congenital biliary dilatation (CBD). A 3-year-old Japanese boy was admitted to our hospital with abdominal pain and vomiting. Computed tomography and magnetic resonance imaging demonstrated a dilated extrahepatic bile duct. A diagnosis of Todani's type 1a CBD was made. Intraoperative cholangiography demonstrated the presence of pancreaticobiliary maljunction but could not reveal any tumor lesion in the bile duct. The excision of extrahepatic bile duct and gallbladder and Roux-en-Y hepaticojejunostomy were performed. On gross inspection, we could not find any tumor lesion in the resected specimen. However, the postoperative histopathologic examinations confirmed the presence of well-differentiated tubular adenocarcinoma with lymphovascular invasion. Most of the carcinoma remained within the mucosal layer, and the carcinoma was identified at both the distal and proximal surgical margins of the bile duct. We scheduled additional surgery to eradicate the residual carcinoma, but informed consent for the extra surgery could not be obtained. A close follow-up with abdominal computed tomography has been going on without either additional surgery or adjuvant chemotherapy about for 1 year. The patient has so far been clinically doing well without any obvious symptoms of recurrent disease. To our knowledge, this report is the youngest case of CC associated with CBD.
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PMID:Invasive cholangiocarcinoma identified in congenital biliary dilatation in a 3-year-old boy. 1994 33

A 3 yr old boy presented with abdominal pain, fever and red jelly stools. Intussusception was diagnosed and effectively reduced with air insufflation. However, despite an improvement in his clinical condition, the child remained febrile and miserable; 5 days later he developed characteristic signs of Kawasaki disease and was treated with intravenous immunoglobulin and high dose aspirin with good results. Intussusception prior to the typical features of Kawasaki disease has not been described previously in the English literature. This case illustrates a novel presentation of Kawasaki disease.
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PMID:Kawasaki disease presenting with intussusception: a case report. 2018 Sep 74

Clinical cases involving paracoccidioidomycosis in children, diagnosed in Mato Grosso State, in the central western region of Brazil, are rare despite the state being classified with a moderate to high incidence. We describe a clinical case of infant acute disseminated Paracoccidioidomycosis in Mato Grosso State, Brazil, highlighting the importance of early differential diagnosis from other severe pathologies, thus contributing to the survival of compromised patients. A 3 year-old male child, weighing 12.8 Kg, originating from Vila Rica, MT, Brazil. The patient presented intermittent 40 masculineC fever evolving over 40 days, dry cough and painless bilateral cervical adenomegaly, showing no signs of inflammation. This was associated with diarrhea, distension and important abdominal pain and weight loss. Diagnosis was achieved by visualization of Paracoccidioides brasiliensis yeasts in a direct mycological exam and posterior fungus isolation in culture medium. The patient evolved presenting good clinical response to antifungal treatment and progressive reduction of abdominal and cervical ganglions. To improve the prognosis of compromised patients it is essential that professionals realize a full clinical-laboratorial evaluation, including differential diagnoses for other severe pathologies, as early as possible. The degree and intensity of paracoccidioidomycosis compromise are determining factors for defining the most efficient treatment.
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PMID:Acute disseminated paracoccidioidomycosis in a 3 year-old child. 2019 Dec 6


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