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

Intussusception of the defunctionalized intestinal segment following jejuno-ileal bypass for obesity has rarely been reported. Persistent crampy abdominal pain (often accompanied by nausea and vomiting) and normal radiologic evaluation are suggestive of this entity. The routine use of silver clips, although helpful in some instances, cannot exclude this diagnosis. A high index of suspicion and the use of sonography may prove that intussusception of the defunctionalized segment is more common than has been previously reported.
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PMID:Intussusception of the excluded segment following jejuno-ileal bypass. 44 76

We report the first known case of syphilitic gastritis in an HIV-infected person. The presentation of nonspecific abdominal pain and weight loss in a 48-yr-old former intravenous drug user previously treated for asymptomatic syphilis led to a barium swallow which demonstrated linitis plastica. Upper endoscopy reinforced a suspicion of carcinoma, but biopsy made the diagnosis of syphilis by silver staining. Further testing revealed a positive serology for syphilis as well as HIV infection with a depressed CD-4 lymphocyte count. Treatment with parenteral penicillin led to a rapid resolution of symptoms. This case represents a rare complication of late syphilis, and is another example of the unusual manifestations of syphilis seen in the HIV-infected population.
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PMID:Syphilitic gastritis in an HIV-infected individual. 144 50

Twenty-six children aged from 1 day to 15 years (18 boys and 8 girls) with visceral neuropathies are analyzed. Clinical symptomatology is dominated by abdominal distension, attacks of occlusion, abdominal pain, and malnutrition. Intestine bacterial overgrowth is frequent. From aspiration biopsies, surgical rectal biopsies, and, in some cases, ileal or ileocolic biopsies, histopathological studies revealed two patterns. One group had abnormalities of the myenteric plexus identified by conventional light microscopic studies, with two patterns: [myenteric plexus hyperplasia (9 patients), characterized by large ganglionic nodes, penetration into the mucosal zone, and altered argyrophilic neurons]. Clinically this pattern was observed in four patients with multiple endocrine neoplasia syndrome with risk of medullary thyroid carcinoma. The second pattern observed was characterized by glial cell hyperplasia (15 patients). Ganglion cells are present but are small and sparse, often infiltrated by collagen tissue; Schwann nerve fibers are hypertrophic. Eleven patients presented with neonatal intestinal obstruction. The second group is characterized by normal conventional light microscopic examination, but silver stains revealed important abnormalities of argyrophobic cells (one case) or argyrophilic cells (one case). In the two groups, most of the patients needed intestinal derivation and prolonged nutritional support with total parenteral nutrition.
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PMID:Visceral neuropathies responsible for chronic intestinal pseudo-obstruction syndrome in pediatric practice: analysis of 26 cases. 239 57

An outbreak of acute gastroenteritis in a kibbutz in southern Israel, characterized by diarrhea, fever, vomiting, and abdominal pain, involved 32 kibbutz members of all ages. Nineteen percent of the children and 3.5% of the adults were ill. Transmission of the illness occurred in direct proportion to the degree of close contact, involving first infants, then mothers and nursery staff, and only later youngsters, adolescents, and fathers. Stool samples obtained from 32 kibbutz members with clinical illness and from 44 asymptomatic close contacts were examined for the presence of rotavirus antigen. Fifty-six percent of symptomatic members were positive for rotavirus antigen as compared with 4.5% of asymptomatic close contacts. Positivity of stool samples correlated inversely with the number of days elapsed after onset of illness until the sample was obtained. Serologic studies carried out on acute and convalescent sera of symptomatic and asymptomatic subjects further supported a rotavirus etiology for the outbreak. RNA profiles of stool sample extracts obtained by polyacrylamide gel electrophoresis and silver staining indicate that one electropherotype may have been responsible for the outbreak.
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PMID:Involvement of infants, children, and adults in a rotavirus gastroenteritis outbreak in a kibbutz in southern Israel. 301 79

A 36-year-old man in otherwise good general condition and with completely normal laboratory results suffered from right upper abdominal pain. Hepatomegaly was diagnosed as due to cystic liver disease after ultrasound, computed tomography and magnetic resonance imaging. Recurrent abdominal pain continued over several months. Open liver biopsy eventually revealed trabecular-tubular carcinoma (APUDoma). Silver reaction was positive in many tumour cells. Electronmicroscopy demonstrated membrane-bound granules typical for endocrine cells. Immunohistological examinations of various hormones and of neurone-specific enolase were negative, but repeatedly measured high serum levels of pancreatic polypeptide and of beta-HCG nonetheless suggested an endocrine tumour. This case demonstrates that nonparasitic cystic changes in the liver, especially multiple ones, should have a firm diagnosis established by invasive means. Endocrine tumours can be mistaken for polycystic liver disease.
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PMID:[Liver apudoma simulating cystic liver]. 331 78

A previously well 39-yr-old man presented with a 4-wk history of abdominal pain, nausea, vomiting, and weight loss. An upper gastrointestinal examination showed retained food in the stomach and duodenal dilatation. A radioisotope meal showed little gastric emptying; esophageal manometry was normal. Because of persistent symptoms, a duodenojejunostomy was done. However, the patient remained symptomatic and after an episode of profuse vomiting, aspirated and died 10 wk after initial presentation. At autopsy, no tumor was found. Hematoxylin and eosin stains throughout the gastrointestinal tract showed many lymphocytes and plasma cells within the myenteric plexus. Silver stains showed the argyrophilic and argyrophobic neurons to be normal, but axons showed beading, fragmentation, and dropout in all areas. We therefore concluded the following: intestinal pseudoobstruction can be caused by an inflammatory neuropathy of the myenteric plexus, not associated with a distant carcinoma, and this process produced an axonopathy while sparing neuron bodies.
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PMID:An inflammatory axonopathy of the myenteric plexus producing a rapidly progressive intestinal pseudoobstruction. 375 92

100 women ranging in age from 26-34 years were followed up for 4-21 months after undergoing sterilization by tubal occlusion using intraluminal threads and silver clips. The number of children/woman ranged from 1-5 with 80% having 2. 31 women underwent sterilization postmenstrually, 11 midmenstrually, 28 premenstrually, 12 after abortion, and 8 during lactation. The timing was unknown in 8 cases. The silver clips used were hook eye "db" shaped, 3 mm wide, .5 mm thick, and 70, 100, or 150 mg in weight. Local anesthesia, suprapubic small abdominal incision, and oviduct delivery were the usual procedures. The clips were placed where the tube is relatively straight and avascular, often near the isthmus or ampulla. No. 4 nylon thread was drawn through the tube and a silver clip was put on each tube and tightened until the threads could no longer be moved. The extra thread was snipped off about 3 mm from the clip. There were no pregnancies among 95 patients followed up. 18 patients had varying degrees of lumbago or leg pain and 1 complained of serious lower abdominal pain, especially after coitus. Pelvic examination in 74 patients showed 1 case of slight thickening in the right appendix region but no pelvic masses. Hysterosalpingography in 22 patients showed 1 case with incomplete occlusion on 1 side. The method is believed to be safe and suitable for use in smaller hospitals and outpatients. Reversibility has been demonstrated in rabbits.
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PMID:Oviduct occlusion by intraluminal thread and silver clips. 641 60

A 16-year-old Caucasian male presented with nausea, vomiting, and abdominal pain. Endoscopy revealed erythematous antral mucosa with four discrete gastric ulcers. Biopsies showed multiple spiral organisms, 4-6 microns in length, lying in the mucous layer on the surface. The organisms were strongly Giemsa positive and weakly CLOtest positive. They did not stain with Warthin-Starry silver or Gram-Weigert stains. Electron microscopy revealed fragments of Gastrospirillum hominis, with its characteristic spiral shape and length of 4 microns in the plane of section. We believe that this is one of the first reported pediatric cases in North America.
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PMID:Gastrospirillum hominis-associated chronic active gastritis. 859 29

Pancreaticobiliary maljunction (PBM) usually is associated with choledochal cyst. PBM without dilatation of the common bile duct is rare in infants and children. This rare type of the anomaly may lead to the development of malignancy of the bile duct in later life. The authors report the clinical presentation and surgical treatment of seven pediatric patients with PBM. Symptoms and signs included repeated episodes of abdominal pain (7 of 7), nausea and vomiting (6 of 7), intermittent jaundice (3 of 7), and acholic stools (2 of 7). Some patients presented with high levels of serum and urinary amylase. These symptoms and signs might have been related to the temporary obstruction of bile flow in the common channel, where endoscopic retrograde cholangiopancreaticography (ERCP) disclosed a protein plug in four of the patients. The common bile duct proximal to the junction of the main pancreatic duct was excised, and a Roux-en-Y hepaticojejunostomy reconstruction was performed. To prevent iatrogenic injury of the main pancreatic duct, repeat cholangiography was performed with the aid of radiopaque silver clips placed on the line of dissection to evaluate the distance between the site of dissection and the main pancreatic duct. All patients have been free of symptoms since the surgery. PBM without dilatation of the common bile duct can be detected more frequently if ERCP is performed on every patient who has repeated episodes of abdominal pain refractory to conventional therapy. Complete excision of the common bile duct and gallbladder followed by hepaticojejunostomy is recommended for PBM, while the goals of decreasing the high risk of carcinoma of the bile duct and preventing recurrent symptoms.
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PMID:Pancreaticobiliary maljunction without choledochal cysts in infants and children: clinical features and surgical therapy. 874 17

Helicobacter pylori-like organisms (Hp) and polymorphonuclear leucocytes (PMNs) in 2614 gastroduodenal biopsies from 602 patients with dyspepsia, in Al Ain, United Arab Emirates, between October 1990 and October 1992, were histologically graded to determine the prevalence of Hp gastritis and their utilization in the evaluation of treatment efficacy in these patients. Symptoms of functional dyspepsia included, in order of frequency, abdominal pain or discomfort, flatulence, burning sensation, regurgitation, fullness, nausea, vomiting, bloating and belching. The biopsies were paraffin embedded, sectioned and stained with hematoxylin and eosin (H and E) to grade the inflammation. In addition to H and E, several special stains including modified Giemsa (MG), Wharthin-Starry silver and cold Ziehl-Neelsen stains were utilized to clearly identify Hp organisms. Giemsa method was found to be superior to other special stains in visualizing the Hp organisms in paraffin sections, and was utilized in every case. Two immunohistochemical markers for B cells (CD20) and T cells (CD45RO) were utilized for labeling lymphocytes infiltrating the lamina propria of the gastroduodenal biopsies in formalin-fixed paraffin-embedded sections. H and E and MG stained sections were utilized to count PMNs and Hp, and were graded 0, 1, 2, and 3, corresponding to none, mild, moderate, and severe grades of the Sydney system for classification of gastritis, respectively. Of the total initial 2318 endoscopic biopsies, 98.8% of the patients had suitable biopsies for histologic evaluation. Unsuitable biopsies were recovered from patients with gastric carcinoma. Inflammation was seen in 98.5% of 595 patients with suitable biopsies. In 74.5% of these patients the inflammation was active; 37.5, 32.5 and 4.5% had mild, moderate and severe active inflammation, respectively. In the remaining 24% of the 595 patients, the gastritis was chronic without activity or atrophic changes. As many as 73.6% of the patients with suitable biopsies were Hp positive; 39.8, 29.1 and 4.7% had grades 1, 2 and 3 Hp, respectively. Intestinal metaplasia was found in 28.9% of the 602 patients, and was seen more often in Hp positive than Hp negative patients (34.5 vs 14%, P < 0.005, for d.f. = 1; chi 2 = 10.35). Of the Hp positive patients, 172 and 46 patients attended the first and second follow-up endoscopy visits, respectively. The triple treatment was composed of one dose of tinidazole (2gm), doxycycline, 200 mg initial dose and 100 mg daily for two weeks, and bismuth subcitrate (Gist-Brocades nv, Delft, The Netherlands), 2 tablets twice daily for 4 weeks. After triple drug treatment, eradication of Hp was accomplished, histologically, in 38.4 and 45.7% of the patients on first and second follow-up visits, respectively. Thus, the Sydney system-based grading scale provides an objective histological evaluation of Hp gastritis for accurate prevalence studies, and may prove to be of value in estimating treatment efficacy.
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PMID:Grading Helicobacter pylori gastritis in dyspeptic patients. 881 77


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