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

After experiencing intermittent episodes of abdominal pain for two years, a 28-year-old woman developed partial small bowel obstruction. Barium enema and colonoscopy revealed the source of obstruction to be an apparent cecal carcinoma. At exploratory laparotomy a primary adenocarcinoma of the appendix with bilateral Krukenberg ovarian metastases was found. This is a rare occurrence and, to our knowledge, the first well-documented case in the English literature. These case also demonstrates difficulties in the preoperative diagnosis of adenocarcinoma of the appendix.
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PMID:Primary mucinous adenocarcinoma of the appendix with bilateral Krukenberg ovarian tumors. 21 Mar 9

Since May 1976, the Olympus pansigmoidoscope has been available for routine use at the University of Oregon Health Sciences center. Two hundred sixty-five examinations were performed over the next year. The average distance examined was 49 cm. Time per examination ranged from 3 to 15 minutes, with an average of 8 minutes. Preparation consisted of one or two tap water enemas, except in known inflammatory bowel disease where no preparation was given. No patient received sedation and there were no complications. Small biopsy (2.8 mm), large biopsy (4.0 mm), "hot biopsy" and polypectomy were performed when indicated. The procedure was most helpful for the following indications: 1) differential diagnosis and follow-up of inflammatory bowel disease, 2) hematochezia, 3) evaluation of abnormal barium enema, 4) left-sided polypectomy, 5) diarrhea with normal barium enema, and 6) guaiac-positive stools. It was of no value in patients with abdominal pain with normal barium enema. Comparing the frequency of examinations this year with last year we found a 50% decrease in use of the rigid (25 cm) sigmoidoscope (538 to 270 exams) and a 98% decrease in use of the MB2 (100 cm) colonoscope (80 to 2 exams).
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PMID:The pansigmoidoscope: one year's experience in a gastrointestinal diagnostic unit. 26 29

Intrapancreatic cysts were demonstrated by endoscopic retrograde pancreatography (E.R.P.) in nine patients with a clinical diagnosis of relapsing pancreatitis. The cysts ranged in diameter from 0.6 cm to 5 cm and were frequently associated with a prolonged elevation of the serum amylase level. The complication of intracystic haemorrhage with obstructive jaundice developed in one patient requiring early surgical decompression and drainage. In four patients laparotomy was performed because of continuing abdominal pain. One patient was treated by cystogastrostomy and another by cyst aspiration, but in two patients the cyst could not be visualized or palpated. Four patients were observed without operation for periods of four to 24 months, and all showed improvement or resolution of symptoms. E.R.P. was repeated in one patient and the cyst could not be outlined, while in another an abnormal barium meal X-ray examination result reverted to normal. Intrapancreatic cysts can be managed non-operatively, since complications appear infrequent and spontaneous resolution may occur.
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PMID:Intrapancreatic cysts associated with relapsing pancreatitis. 28 28

A case of paraprosthetic-enteric fistula is presented and the total reported literature of 21 cases is reviewed. Paraprosthetic-enteric fistula is a complication of aortic revascularization with synthetic prostheses. The entity is characterized by erosion of the gastrointestinal tract by an underlying prosthesis but absence of a true fistulous communication with the aortic lumen. It is both a distinct pathologic entity and a step in the formation of a true aortoenteric fistula with suture line involvement. The most frequent clinical manifestations are sepsis and gastrointestinal bleeding, but nonspecific abdominal pain is present occasionally as well. The distal duodenum is the portion of the gastrointestinal tract involved most commonly. Diagnostic evaluation should include endoscopy, aortography, and barium contrast studies. Venous and femoral arterial blood cultures also should be done in patients presenting with sepsis. Treatment should consist of either graft excision with extra-anatomic revascularization or graft excision alone when dealing with a previously thrombosed prosthesis.
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PMID:Paraprosthetic-enteric fistula. 30 May 10

Records of 1084 patients entered into the National Cooperative Crohn's Disease Study were analyzed to gather information concerning the natural history and clinical features of Crohn's disease. The age of onset reached a single peak between the second and fourth decade and was evenly distributed in both sexes. There was an average interval of 35 mo from onset of symptoms to diagnosis. Involvement of both colon and terminal ileum was the most frequent pattern and was present in 55% of patients. The disease was confined to the terminal ileum, other areas of the small intestine, or colon-only in 14%, 3%, and 15% of patients, respectively. Sigmoidoscopic abnormalities were seen in 34% of all patients and 51% of patients with Crohn's colitis. Diarrhea, abdominal pain, weight loss, and fever were present in the majority of the patients. Lower GI bleeding, fever, and perianal complications characterized patients with colon-only involvement. The frequency of extra intestinal manifestations was similar in all groups. Among patients who were randomized to placebo, 32% achieved a spontaneous remission by the end of 17 wk, and 53% of these were still in remission at the end of 24 mo. Clinical remission was associated with an improvement in barium x-rays in 18% of the patients. The predicted factors associated with favorable outcome in placebo-treated patients were: previous surgical removal of all observable disease, absence of perianal disease, and Crohn's Disease Activity Index value under 200.
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PMID:Clinical features and natural history of Crohn's disease. 38 Oct 94

The results of the radiological examination of 330 children following oral administration of barium are reported. It is pointed out that if one just takes into account the undoubted organic diseases, only a few children would benefit from the examination; in our case only 9 of them (a gastric and a duodenal ulcer, a pancreas pseudocyst, 5 hiatal hernias, and a celiac disease), i.e. 3%. This is not very satisfactory from a practical point of view. This situation improves radically when one looks for diseases usually rated as questionable: small hiatal hernia (cardiotuberositary malposition), functional disturbances of the small intestine, reactive hyperplasia of the lymphoid tissue, and chronic appendicitis. Thus we were able to offer 177 children, i.e. 53% of them, an efficacious therapy. The importance of chronic appendicitis and of functional disturbances of the small intestine as a cause of abdominal pain in children is pointed out, and their radiological symptoms are discussed. Finally the not uncommon, but not very well known disease of incomplete sigmoid volvulus is described.
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PMID:[Radiologic findings in abdominal pain in children (author's transl)]. 42 1

The radiographic appearance and clinical significance of gastric varices in the absence of esophageal varices and secondary to splenic vein occlusion were studied. Eighteen patients were evaluated through medical records, angiography, and barium studies of the stomach and esophagus. The presence of splenic vein occlusion was determined by arteriography in 18 patients and its etiology confirmed by surgery in 17 patients. This condition should be suspected in patients with chronic abdominal pain, weight loss, and iron deficiency anemia who show fundal polypoid filling defects or prominent gastric folds on an upper GI series.
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PMID:Gastric varices secondary to splenic vein occlusion: radiographic diagnosis and clinical significance. 47 32

Ischemic colitis is a well described complication following distal aortic replacement. The diagnosis is typically made by correlating clinical signs such as the occurrence of abdominal pain and bloody diarrhea with supporting radiographic changes. In this report, the diagnosis of ischemic colitis was confirmed on the basis of colonoscopic and associated histopathological findings. Colonoscopy is a useful technic in establishing the diagnosis of ischemic colitis, especially in patients whose clinical condition makes barium enema not feasible.
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PMID:The endoscopy corner: reversible ischemic colitis--correlation of colonoscopic and pathologic changes. 47 61

Right paraduodenal hernias are a relatively rare congenital malformation with a total of 50 clinical cases having been reported. This anomaly can be seen as total encapsulation of the small bowel or a single loop within a hernia sac. Symptoms are often chronic vague abdominal pain and intermittent obstructive episodes. Barium studies in patients with moderate and large defects, and angiography in small hernias may provide the diagnosis. The method of repair is dependent on the size of the hernia encountered. The management of two patients with this problem is described.
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PMID:Right paraduodenal hernia: a source of chronic abdominal pain in the adult. 48 40

The symptoms, diagnosis, and management of three patients with gastrocolic fistula secondary to benign peptic ulcer disease are reviewed. To our knowledge, this brings the total of such cases reported in the literature to 50. The most frequent symptoms were abdominal pain, weight loss, diarrhea, and vomiting followed by anemia, foul eructations, and fecal vomiting. Barium meal demonstrated the fistula in about 70% of the patients, whereas barium enema examination demonstrated the fistula in nearly all of them. The diagnostic workup should rule out the possibility of a malignant cause for the fistula. The surgical management of these patients consists of the one-stage, when possible, resection of the involved portion of the antrum and the fistula of the transverse colon with appropriate reconstruction of gastrointestinal continuity. An increased awareness of the benign cause of some gastrocolic fistulas is necessary to avoid unduly extensive surgery in these cases.
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PMID:Gastrocolic fistula as a complication of benign gastric ulcer. 53 62


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