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

Serial changes in thyroid hormone levels are described in two patients in whom hyperthyroidism was associated with transient non-thyroidal illness. In a 74-year-old woman with mild hyperthyroidism, two episodes of cholecystitis were associated with subnormal concentrations of serum T3 and increased concentrations of serum rT3; T3 became elevated during recovery, associated with a simultaneous fall in rT3. The TSH response to TRH was undetectable on three occasions. A cholecystectomy was performed after preparation with Lugol's iodine and subsequent tests showed evolution through T3 toxicosis to classical hyperthyroidism. In the second case, symptoms and signs of classical hyperthyroidism were noted during an undiagnosed illness characterized by severe abdominal pain and fever. Six days after the onset of this illness, an elevated level of serum T4 was associated with a normal total T3 concentration and increased concentration of rT3. After resolution of abdominal symptoms, serum T3 was markedly increased, associated with persistent T4 and rT3 excess. These findings indicate that the changes in T3 and reverse T3 described in non-thyroidal illness also occur in hyperthyroid patients, and suggest that the fall in T3 may be of sufficient magnitude to make T3 measurement diagnostically unreliable in the presence of non-thyroidal illness.
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PMID:Hyperthyroidism without triiodothyronine excess: an effect of severe non-thyroidal illness. 10 56

Internal radiation therapy with subsegmental arterial injection of iodine 131(131I)-labeled iodized oil (Lipiodol; Laboratorie, Guerbet, France) was evaluated in 24 patients with nodular hepatocellular carcinoma (HCC) ranging from 2.5 to 8.0 cm in size. 131I Lipiodol (555 to 2220 MBq in 3 to 8 ml) was injected depending on the tumor size. Tumor reduction was seen in 88.9% of tumors smaller than 4.0 cm in diameter, 65.5% of tumors between 4.1 to 6.0 cm, and 25.0% of tumors larger than 5.1 cm. The tumor size reduction corresponded to the gradual drop of serum alpha-fetoprotein (AFP) levels and devascularization on follow-up angiography. Adverse reactions from treatment included fever, mild abdominal pain, nausea, and elevation of transaminases. These were mild and well tolerated by patients. This method provided long-term local control without complications related to the thyroid, lung, gastrointestinal tract, and bone marrow.
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PMID:Nodular hepatocellular carcinoma. Treatment with subsegmental intraarterial injection of iodine 131-labeled iodized oil. 171 29

Twenty four patients with hepatocellular carcinoma who refused surgery or had unresectable tumor ranging 2.5 to 8.0 cm in size were treated with intrahepatic arterial injection of iodine-131-labeled iodized oil (I-131 Lipodol) in an attempt to achieve internal radiation of tumor. 555-2,220 MBq in 3-8 ml of I-131 Lipiodol was injected into the hepatic artery or proximal to the tumor feeding vessel depending on the tumor size. Tumor size reduction was observed in 88.9% of tumor smaller than 4.0 cm in diameter, 65.5% between 4.1 to 6.0 cm, and 25.0% of larger than 6.1cm, respectively. The tumor size reduction was corresponded to the gradual drop of serum AFP levels, decreased uptake on gallium-67 scintigraphy, and devascularization on follow-up angiography. Tumors having significant A-V shunts revealed further tumor growth. Adverse reactions from the treatment include fever, mild abdominal pain, nausea and elevation of transaminases. These have been mild and well-tolerated by the patients. This method was able to provide long term local control without complications related to thyroid, lung, GI tract and bone marrow.
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PMID:Nodular hepatocellular carcinoma--treatment with intraarterial injection of I-131 Lipiodol. 217 7

A Down's syndrome patient was hospitalized for evaluation of vomiting, abdominal pain, and a history of weight loss. A subsequent workup revealed that she had hyperthyroidism. The treatment of choice was radioactive iodine therapy. The patient had a history of consistent nausea and incontinence for urine and feces. Special problems posed by the patient and radiation safety are discussed.
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PMID:Treatment of a Down's syndrome patient for hyperthyroidism with radioactive iodine. 293 92

A 48-year-old woman with a known history of hypothyroidism was admitted to the intensive care unit with a diagnosis of thyroid storm secondary to acute thyroid hormone poisoning and the possible hyperfunction of a singular thyroid nodule. Her clinical manifestations included pyrexia, tachycardia, tachypnea, hypertension, RUQ abdominal pain, psychotic behavior, and pharyngitis. She was successfully treated with sodium iodide, PTU, propranolol, antibiotics, and a hypothermia mattress, with her serum T4 level returning to normal range prior to discharge. The patient was discharged 9 days after admission in good medical health with no medication. This article clearly shows that the functions of the endocrine system remain a frontier in today's medicine. With research, perhaps one day we might fully understand the intricate pathophysiology that results in thyroid storm. The potential problem format has been utilized in the development of the nursing care plan to assist the nurse with identifying and defining her patient's problems, as well as directing her assessment and nursing intervention. As more is learned about thyroid storm, nurses should update their knowledge so that they will be prepared to care for the patient with these difficult nursing problems.
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PMID:Thyroid storm--a nursing crisis. 655 51

Positive contrast herniography has been used in adult patients with unexplained groin pain for the detection of clinically occult inguinal hernias. Herniography involves puncture of the anterior abdominal wall and injection of an iodine contrast medium. Complications may be encountered from either phase of the procedure and were recorded in 19 (5.8%) of 330 herniographies. Difficulties in puncturing the abdominal wall as well as in injecting the contrast medium were noted in 12 (3.6%); these difficulties included injection into the stomach (one patient), left iliac vein (one patient), colon (three patients), and anterior abdominal wall (four patients). In three patients a painful hematoma developed at the site of puncture. Adverse reaction to the injection of contrast medium (80 ml meglumine metrizoate, 200 mg l/ml) was noted in seven (2.1%) patients. Five of these had a vasovagal reaction and two developed severe abdominal pain within a few hours after the examination. They were hospitalized for 24 hr due to suspected peritonitis. When 52 consecutive patients were asked about pain during or after the injection of contrast medium, 15% described severe pain while 23% admitted moderate pain. As in other invasive examinations, herniography involves a certain risk. This study shows that complications occur with the same or lower frequency than in urography.
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PMID:Complications after herniography in adults. 660 May 40

The prevalence of intestinal protozoa and geohelminths was assessed among two diverse populations in the Kandy area: adults attending medical outpatients clinics at the Teaching Hospital Peradeniya, and pre-school children in low-cost housing areas within the Kandy Municipality. In addition to a brief history and examination, a fresh stool sample was obtained and examined by direct smears in saline and iodine, and by formol-ether concentration. The children's stool samples were also examined for Cryptosporidium by cold Ziehl-Neelsen staining. A total of 192 stool samples from the adult outpatients (101 males, age range 15-82 years, mean 51.4 years) and 354 samples from the pre-school children (age range 1-72 months, mean 30 months) were examined. Entamoeba histolytica was not seen in any of the samples; Giardia cysts and Cryptosporidium oocysts were seen in three and one sample respectively from the pre-school children. The overall prevalence of geohelminth infections was 21.3% among the adults and 24.5% among the children. Ascaris lumbricoides was the predominant species in both populations. Comparison of the rate of intestinal parasite infection among 37 adult patients patients with non-specific abdominal complaints, with the rate among 37 matched controls with no abdominal complaints showed no significant difference (16% and 19% respectively). This suggests that the presence of abdominal pain or diarrhea was unrelated to the presence of intestinal parasites in the adult study population. Although the techniques used were not highly sensitive, the absence of E. histolytic probably reflects a true decline in the prevalence of this parasite in Sri Lanka.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Intestinal parasitoses in the Kandy area, Sri Lanka. 777 9

A 35-year-old, previously healthy woman, known to be thyrotoxic, was transferred from a community hospital for "acute abdomen." Abdominal pain, distention, and hyperemesis resolved with placement of nasogastric tube (NGT) and return of 2,600 mL of bilious fluid. Continued high NGT output made oral or NGT administration of antithyroid drugs impossible. We gave propylthiouracil (PTU) by retention enemas with therapeutic serum levels and sublingual saturated solution of potassium iodide (SSKI) with 70% absorption based on 24-hour free iodine urinary excretion. The patient's thyroxine (T4) and triiodothyronine (T3) radioimmunoassays were normal on hospital days 10 and 12, respectively. However, free T4 and T3 resin uptake did not normalize until hospital day 31. On hospital day 32, she tolerated removal of NGT without nausea and 4 days later was taking a regular diet. We conclude that our patient's gastrointestinal symptoms were a prominent feature of her thyrotoxicosis and that rectal PTU and sublingual SSKI are effective in administration of antithyroid drugs.
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PMID:Duodenal obstruction in thyroid storm. 938 60

A prospective, observational study was performed to define the laparoscopic appearance of chronic or recurrent appendicitis, and to evaluate a new, simplified technique for laparoscopic appendectomy. Chronic appendicitis was assumed in 42 women with long-term or recurrent lower abdominal pain, and appendectomy was performed when two or all three of the following pathologic changes, which were highly predictive of the diagnosis, were present: vascular injection of appendiceal peritoneum, periappendiceal adhesions, and induration of the appendix. After thorough periappendiceal adhesiolysis, a catgut no. 2 endoloop was placed around the base of the appendix and mesoappendix. The appendix was skeletonized, crushed distal to the ligature, regrasped further distally while simultaneously closing the appendiceal lumen, and cut in the crushed area. It was removed retrograde through the left suprapubic 10-mm port. Iodine was applied to the stump. No major intraoperative or postoperative complications occurred. During mean observation of 12.6 months, 74% of women were free of abdominal pain, 12% had partial relief in a mean of 15.4 months' observation, and 12% experienced no change in abdominal pain. This technique is safe, simple, and effective when chronic or recurrent appendicitis is assumed during diagnostic laparoscopy for chronic lower abdominal pain.
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PMID:Gynecologically indicated single-endoloop laparoscopic appendectomy. 966 50

Symptomatic lymphocele presented after pelvic lymphadenectomy for localized carcinoma of the prostate is a relatively rare complication. We treated a case of infected lymphocele presenting 4 months after a limited staging pelvic lymphadenectomy and a radical prostatectomy for adenocarcinoma of the prostate. The patient was a 70-year-old Japanese man having the chief complaint of fever, right lower abdominal pain, nausea and vomiting. Pelvic computed tomography showed a 14 cm cystic mass with a thick capsule on the right iliopsoas muscle. It was suspected to be an infected lymphocele. After percutaneous drainage, sclerotherapy (povidone iodine, minocycline and ethanol) and antibiotic drugs, the infected lymphocele was resolved.
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PMID:[A case of delayed infection of a pelvic lymphocele following radical prostatectomy 4 months after operation]. 1296 86


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