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

Fibre-optic endoscopy of the upper gastro-intestinal tract has been successfully performed in 55 patients (60 examinations) with one complication related to general anaesthesia. Fifty-six of these examinations were performed under general anaesthesia in children ranging from 1 to 14 years. Four examinations were done without an anaesthetic. The instruments used were the Olympus GIF-K (forward oblique gastroscope) in the older children and the GIF-P2 (end-viewing paediatric gastroscope) in the younger patients. Indications for examination included gastro-intestinal bleeding, confirmation or exclusion of peptic ulceration as suspected on barium studies, persistent and recurrent vomiting, chronic abdominal pain, and the evaluation of gastro-oesophageal reflux. The need for careful selection of patients is emphasized since general anaesthesia is considered essential in the majority of chidren.
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PMID:Upper gastro-intestinal endoscopy in chidren. 55 Apr 8

The majority of clinically significant gastrointestinal rotational anomalies involve:(1) an arrest of rotation about the superior mesenteric vessels, (2) abnormal peritoneal bands, and (3) obstruction with or without volvulus. Between 1973 and 1978, six children had chronic intermittent volvulus secondary to a nonfixed but normally-rotated intestine; this is 10% of all infants and children treated for malrotation in our hospital during the same period. Barium studies showed normal duodenojejunal configuration and a colon that was normally situated on at least one study. All were labeled as functional complainers by their pediatricians. One died of a volvulus because her complaints were appreciated too late. At laparotomy, evidence of chronic intermittent volulus secondary to nonfixation from the ligament of Treitz to the transverse colon was found in all patients. A Ladd procedure with appendectomy was performed and immediate resolution of symptoms was noted in each surviving child. Children with a story of chronic abdominal pain deserve a carefully interpreted history and radiographic examination before being labeled as chronic complainers.
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PMID:Normal intestinal rotation with non-fixation: a cause of chronic abdominal pain. 55 Nov 42

In three cases of pancreaticocolonic fistula presenting before the stage of exsanguinating hemorrhage of severe sepsis the problem was diagnosed on the basis of the clinical history, visualization of the terminal part of the fistula by roentgenography after a barium enema had been given and, in two cases, demonstration of the communication with the pancreatic ductal system by endoscopic retrograde pancreatography. The lesions were repaired surgically. Pancreaticocolonic fistula should be suspected in a patient with upper abdominal pain who has a history of abdominal pain and excessive alcohol consumption and in whom diarrhea and fever, hematochezia or a disappearing abdominal mass develops. Characteristically barium will collect in the terminal part of the fistula and thus permit a tentative diagnosis; the diagnosis can then be confirmed by endoscopic retrograde pancreatography. With this approach surgical treatment can be carried out earlier and the often fatal course of the disorder can be averted.
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PMID:Pancreaticocolonic fistula: a complication of pancreatitis. 70 71

Five adults with midgut nonrotation were treated at Tripler Army Medical Center between January 1, 1966 and January 1, 1974. These patients usually presented with vague epigastric or lower abdominal symptoms. Initial diagnosis was generally based on barium enema studies revealing an entirely left-sided colon. However, on upper gastrointestinal series the absence of a normal duodenal "c" loop with straightening is also seen. Duodenal obstructive bands are rarely documented radiographically. Surgical intervention is frequently delayed in these patients due to the "atypical" symptoms and lack of correlation of these symptoms with objective radiographic changes. The high incidence of associated duodenal ulcer disease, the frequent occurrence of bowel obstruction, the persistence of chronic abdominal pain in the untreated patients, and the resolution of symptoms after anatomic correction point to the need for an aggressive approach to treatment in those patients who have chronic recurrent symptoms secondary to midgut nonrotation.
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PMID:Midgut nonrotation in adults. An aggressive approach. 80 77

Diverticula rarely occur within the lumen of the duodenum. They arise near the papilla of Vater and extend distally. The diverticulum is lined on both sides with duodenal mucosa, and its eccentric opening is usually proximal in the sac. The diverticulum results from incomplete recanalization of the intestinal lumen after the proliferative epithelial stage in the 7-week embryo and represents either a remnant of one of two channels formed during recanalization or a distal ballooning of a congenital duodenal diaphragm. Although the patient with a diverticulum may be asymptomatic, most patients present with abdominal pain and obstructive symptoms; pancreatitis and gastrointestinal bleeding may be associated with the diverticulum. Barium study shows a characteristic radiolucent halo that represents the wall of the diverticulum. Surgery should be approached with caution because injury to the papilla is a hazard, and in children, coexisting congenital anomalies may be present.
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PMID:Intraluminal duodenal diverticulum. Report of two cases and review of the literature. 80 22

Eleven children with the diagnosis of chronic idiopathic intestinal pseudo-obstruction are presented. Four children, all siblings of a symptomatic patient, were asymptomatic and were diagnosed radiographically. The clinical course was characterized by intermittent episodes of abdominal distention, vomiting, abdominal pain, diarrhea, constipation, and malnutrition. Radiographic studies were most helpful in making the diagnosis. Findings on upper gastrointestinal series included abnormal esophageal motility, delayed gastric emptying, dilated loops of small bowel, and disorganized transit of barium. Half of the patients had abnormal evacuation patterns on barium enema. Manometric studies of esophageal motility were abnormal in seven of ten children. In those patients studied, small bowel and rectal biopsies contained ganglion cells. Treatment was directed at relieving symptoms, which in four patients became persistent and required total parenteral nutrition. CIIPS carries a poor long-term prognosis in children.
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PMID:Chronic idiopathic intestinal pseudo-obstruction syndrome in children--clinical characteristics and prognosis. 83 71

Diagnostic barium enema is not a substitution for well executed physical examination, and its use should be reserved only for obscure situations. An abnormal roentgenogram provides valuable information, since the fear of missing acute appendicitis in these children is minimized. When normal, this diagnostic test may bring to early operation those with minimal symptoms or unusual presentations, thus avoiding the possibility of prolonged observation and perforation. In children with known associated severe medical maladies, diagnostic barium enema can serve to reaffirm the diagnosis prior to the hazardous operative intervention. It may also eliminate the need for operation in those conditions which mimic acute appendicitis. The use of diagnostic barium enema in the past three and a half years significantly improved our diagnostic capabilities in children with abdominal pain. There was a corresponding reduction in the number of normal appendixes removed. The efficancy and, above all, the safety of this procedure make it a valuable diagnostic aid in the care of children.
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PMID:Barium enema as a diagnostic aid in children with abdominal pain. 84 51

Fifteen patients with ischemic colitis were treated; in every case the diagnosis was made at operation or autopsy. Abdominal pain, tenderness, and distention were the most common findings. Five patients had the transient form of the disease, two stricturing, and eight gangrenous. Five patients were operated upon, two because of stricturing disease, three because of gangrene of the colon. Both of the former patients survived, one of the latter. Diagnosis of transient ischemic colitis can be made by barium enema studies. This form of the disease is self-limiting and recovery should be expected. Stricturing ischemic colitis may be diagnosed by barium enema, but doubtful cases will require laparotomy and resection. It is difficult, if not impossible, to differentiate the gangrenous form of the disease from other abdominal catastrophes without operation. When the condition is found at celiotomy, bowel resection without anastomosis is recommended.
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PMID:Ischemic colitis. 84 64

A case of metastatic melanoma of the stomach is reported with illustrative endoscopic and radiographic findings. Metastatic melanoma of the stomach may present with vague gastrointestinal symptoms, abdominal pain, or gastrointestinal bleeding. A history of melanoma may not be readily obtainable. When gastrointestinal symptoms occur in a patient with known melanoma, gastric metastases should be considered. Polypoid or target lesions are frequently seen on barium x-ray study. Small bowel roentgenograms should be obtained. Endoscopy, cytologic study, brushing, and biopsy may yield the diagnosis. The prognosis is poor. Surgery should be performed only to relieve significant symptoms.
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PMID:Metastatic melanoma of the stomach: the endoscopic and roentgenographic findings and review of the literature. 84 97

A 65-year-old man was hospitalised for a subocclusive state, fever, 15 kg weight loss and left abdominal pain. The plain abdominal film revealed gas in the left hypochondrium. Barium enema showed a stenosis of the left colic angle. On evacuation, a little barium entered the gas-filled cavity. Left colectomy with splenectomy was carried out. The pathologist found histological evidence of a small carcinoma of the colon invading the hilum of the spleen. An intrasplenic cavity had been formed at the site of contact. Thus an intrasplenic gas collection was the presenting sign of a carcinoma of the colon. Two colosplenic fistulae of similar origin have been reported in the literature; neither associated with similar radiological findings.
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PMID:[Carcinoma of the left colic angle presenting as an intrasplenic gas collection (author's transl)]. 85 82


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