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

Endoscopic retrograde cholangiopancreatography is a new and valuable technique in the diagnosis of jaundice, pancreatic disease and obscure upper abdominal pain. Endoscopic sphincterotomy of the sphincter of Oddi and the extraction of stones from the common bile duct are an extension of this procedure already in use in several high-volume centres. Cannulation of the bile ducts and pancreatic ducts in tests of secretion and cytology will become increasingly common applications of the technique. In order to provide dependability and cost-effectiveness, specialists in this procedure must maintain a high volume, necessarily limiting it to a few practitioners. Use of a trained endoscopic technician, a radiologist trained in endoscopy, or an endoscopist trained in fluoroscopy and spot-filming may decrease the manpower costs of this procedure.
Can J Surg 1976 Sep
PMID:Endoscopic retrograde cholangiopancreatography in the management of pancreatic and biliary disease. 97 26

A 54-year-old man with acute upper abdominal pain was found to have pancreatic heterotopia in the wall of the gallbladder. The aberrant pancreatic tissue and the gallbladder wall were the sites of acute inflammation and of fat necrosis. Pancreatic heterotopia of the gallbladder is extremely rare; only 10 proven cases have been reported previously. The most common sites are the stomach, duodenum and jejunum.
Can J Surg 1976 Sep
PMID:Acute pancreatitis occurring in heterotopic pancreatic tissue in the gallbladder. 97 27

Endoscopic retrograde cholangiopancreatography (ERCP) was carried out in 98 patients with unexplained abdominal pain or known pancreatitis with recurrent pain. Patients with jaundice were excluded from the study. In 38 patients with a clinical diagnosis of pancreatitis, the radiological findings on ERCP were graded according to the criteria of Kasugai et al. Advanced pancreatitis was found in 20 patients (52,5%), moderate changes in 7 (18,4%) and minimal-change pancreatitis in 6 (15,8%). ERCP had normal pancreatic function tests. In 35 patients investigated for unexplained abdominal pain, changes consistent with pancreatitis were found in 7, pancreatic carcinoma in 5, a duodenal ulcer in 2, gallstones in 1 and a duodenal tumour in 1. ERCP was normal in 19 patients. A comparison of the findings on ERCP and the standard secretin-cholecystokinin pancreatic function test was available in 52 patients. There was a good agreement between the two tests in the patients with advanced or moderate pancreatitis as revealed by ERCP, but less agreement in the patients with minimal-change pancreatitis. A few patients with clinical pancreatitis and abnormal ERCP had normal pancreatic function tests. ERCP increases the diagnostic yield in patients suspected of having pancreatitis and is at present the only reliable method of diagnosing pancreatic carcinoma which is not evident by other non-operative techniques. ERCP is also of value in the assessment of the severity of pancreatitis and is a necessary investigation before pancreatic surgery to confirm or exclude cyst formation or the site of duct obstruction. The finding of an unsuspected cyst at ERCP necessitates early operation because of the danger of introducing infection during the procedure.
S Afr Med J 1976 Sep 11
PMID:Endoscopic retrograde cholangiopancreatography in the evaluation of pancreatic disease. 98 98

Twenty-four patients with spinal cord injuries were studied to correlate their responses to intra-abdominal disease with the level and completeness of the cord lesion. Patients with complete cervical lesions and lesions of the upper part of the thoracic region (C-4 to T-6) usually responded by early noniocalized abdominal pain associated with signs of autonomic dysreflexia. As the disease progressed to involve the parietal peritoneum, these patients were more capable of localizing pain to the corresponding dermatome, whereas patients with incomplete lesions were able to localize their pain earlier. Patients with lumbar lesions and lesions of the lower part of the thoracic region (T-7 to L-3) were able to localize their pain earlier than those with lesions located higher in the thoracic region. All patients had delayed diagnoses except those with hemorrhage of the upper part of the gastrointestinal tract. Irrespective of level of cord lesion, increased pulse rate was themost prominent objective acute intra-abdominal pathologic finding. Shoulder pain in the quadriplegic is a most helpful sign.
Arch Surg 1975 Sep
PMID:General surgery problems in patients with spinal cord injuries. 108 Apr 12

A washout technic with intestinal infusion of an inert gas mixture was used to study the relation of gas to functional abdominal symptoms. The volume of gas in the intestinal tract (176 plus or minus 28 ml S.E.M.) of 12 fasting patients with chronic complaints of excess gas did not differ significantly (P greater than 0.10) from that of 10 controls (199 plus or minus 31 ml). Similarly, there was no difference in the composition or accumulation rate of intestinal gas. However, more gas tended to reflux back into the stomach in patients who complained of abdominal pain during infusion of volumes of gas well tolerated by controls. Six patients with severe pain during the study had intestinal transit times of gas (40 plus or minus 6 minutes S.E.M.) that were significantly (P less than 0.05) longer than those of the control group (22 plus or minus 3 minutes). Thus, complaints of bloating, pain and gas may result from disordered intestinal motility in combination with an abnormal pain response to gut distention rather than from increased volumes of gas.
N Engl J Med 1975 Sep 11
PMID:The role of intestinal gas in functional abdominal pain. 115 77

This case study deals with an eight-year-old girl who developed persistent abdominal pain and vomiting for which no physiological cause could be discovered. After two months of unsuccessful treatment for her illness, the girl was referred for a psychiatric consultation. During the psychiatric interview, the psychogenic nature of the girl's illness became readily apparent, as did the nature of the conflict which had produced it. The tendency is strong for psychogenic illness, such as this, to become chronic without psychiatric treatment. Many physicians are reluctant to apply clinically basic psychiatric techniques to the treatment of physical illness. A suggestion is made that closer collaboration between psychiatry and other medical specialties could be of great value in preventive medicine.
Clin Pediatr (Phila) 1975 Sep
PMID:A case study of neurosis secondary to trauma in an eight-year-old girl. Comments on the tendency for psychogenic illness to become chronic. 115 39

The physiatrist faces two major difficulties when dealing with abdominal problems in spinal cord-injured patients: (1) realizing when there is a serious problem; and (2) determining the etiology of the problem. Patients are presented which demonstrate these difficulties. One patient with a ruptured appendix and the periappendicial abscess had only mild symptoms whereas another patient with severe abdominal pain, rigidity and rebound tenderness had a viral enteritis. The neurologic innervations of the abdomen and the various signs and symptoms appearing in cord-injured patients with abdominal problems are described. A methodical evaluation procedure for acute problems in paraplegic patients is presented.
Arch Phys Med Rehabil 1975 Sep
PMID:Abdominal problems in patients with spinal cord lesions. 116 81

An unusual case of tuberous sclerosis is presented in which splenomegaly and abdominal pain predominated. The clinical manifestations of the disease are discussed, and the generalized hamartonmatous nature of the diseases is emphasized.
Am Surg 1975 Sep
PMID:Hamartoma of the spleen: a manfestation of tuberous sclerosis. 116 74

Over the past 5 years there has been an increase in the number of reports of patients with hepatic adenomas, and an association has been found between these tumors and the use of oral contraceptives. Up to January 1975 46 patients have been reported with this association. The histology of the tumors varies, with several names having been applied to the variations. Adenoma or focal nodular hyperplasia seem to be the most appropriate terms. Most of the commonly used oral contraceptives have been involved. Usually the use of the contraceptive has been at least 2 years. In 1 case, adenoma was diagnosed 4 years after stopping use of the drug. Symptoms have been abdominal pain and an abdominal mass. The tumor may rupture with hemorrhage into the abdominal cavity creating an emergency. Hepatic arteriography has been used to make an early diagnosis. Biochemical tests remain normal. Needle biopsy is contraindicated; surgery is indicated, however. The lesion may be multiple. Hepatic adenoma should be suspected in any young woman with abdominal pain and enlargement of the liver. Ruptured hepatic adenoma should be considered in acute abdominal emergencies, in young women who are taking oral contraceptives, and in older women taking hormone replacements.
Gut 1975 Sep
PMID:Hepatic adenomas and oral contraceptives. 119 29

In the two years - 1st January, 1973 to 31st December, 1974 - 533 patients had operation for tubal pregnancy at the Gynaecology Unit of the Korle-Bu Teaching Hospital. About five cases per week were seen during this period. The incidence was 44 for every thousand deliveries at the Hospital. The case notes of 404 of the 533 patients have been reviewed. The age range was 15 to 44 years; 78% were in the 21 to 35 years age group. 81.4% had had pregnancies which went beyond 28 weeks. Only 13.7% had never had an intrauterine pregnancy. Tubal pregnancy is therefore not a disease of the primarily infertile as is commonly thought. There was no significant difference between the incidence on the right side and the incidence on the left side. The ampulla was the commonest site of implantation in the tube (45%). Tubal rupture (89.6%) was commoner than tubal abortion (10.4%). The principal signs and symptoms were abdominal pain, amenorrhoea, abdominal tenderness, abdominal distension, and signs of free fluid in the abdomen, syncope, anomalous vaginal bleeding, pallor and vomiting. The absence of amenorrhoea does not rule out the possibility of an ectopic. On pelvic examination the major signs were tenderness in a fornix and cervical excitation pain. Abdominal paracentesis and culdocentesis if positive are useful in diagnosis; negative results prove nothing. Laparascopy is of great value and should be employed in the difficult case. Beware of the patient in the reproductive age with anomalous vaginal bleeding, vague abdominal pains, syncopic attacks and anaemia. The mortality rate in the series was 0.7%.
Ghana Med J 1975 Sep
PMID:Tubal pregnancy: a review of 404 cases. 123 87


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