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

Investigation was undertaken on a patient whose long-term intake of desipramine hydrochloride was amongst the highest reported. Desipramine treatment instituted at a daily dosage of 75 mg for depressive equivalents of head, chest, and abdominal pain was increased to 1,000 mg daily over a 12-year interval with minimal side effects. Plasma desipramine level dropped immediately on withdrawal, and urinary metabolite values dropped over the subsequent five days. The electrocardiographic abnormalities of first-degree atrioventricular block and incomplete left bundle branch block rapidly disappeared on cessation of medication. Electroencephalographic changes with symmetrical generalized irregular 5- to 7-cps theta activity and 18- to 28-cps beta activity also improved. Longitudinal polygraphic sleep studies showed prolonged rapid eye movement rebound and increased delta sleep coincident with withdrawal. It took ten days after cessation of desipramine for urinary 3-methoxy-4-hydroxyphenylglycol concentration to increase substantially. Although catecholamines are involved in growth hormone (GH) and cortisol regulation, no abnormalities were found in GH or cortisol levels.
Arch Gen Psychiatry 1978 Oct
PMID:Withdrawal from long-term high-dose desipramine therapy. Clinical and biological changes. 21 86

I report five cases of occlusion of the superior mesenteric artery from one general practice; four of these occurred in one year.THE COMMON CLINICAL FEATURES WERE: acute diarrhoea and vomiting in elderly persons (all over 70) with abdominal pain and distension and shock. All had a previous history of auricular fibrillation and cardiac failure and past episodes of clinical arterial occlusive disorders had been experienced by four. Each diagnosis was confirmed at operation and all five patients died. It is important for general practitioners to recognize this syndrome.
J R Coll Gen Pract 1979 Sep
PMID:Acute superior mesenteric artery occlusion: problems of pre-operative diagnosis. 52 38

A questionnaire survey of 120 children with migraine showed an average age of onset of 5.15 years, an equal sex ratio under nine years, and a positive family history in 79 per cent. Eye symptoms (42 per cent) and headaches (32 per cent) heralded an attack, with abdominal pain and vomiting later and less frequent. Visual aura was not recognized under five years, but occurred in 52 per cent of the 13 to 15 year age group. Most attacks occurred on schooldays and 82 per cent were over within two days.The 24-hour food intake before an attack was compared with the food intake seven days later when no migraine occurred. This suggested that fasting (41 per cent) or specific foods (38 per cent) could have been responsible for many of the attacks.
J R Coll Gen Pract 1979 Nov
PMID:Food intake before migraine attacks in children. 54 7

One hundred and sixty-two children (57 boys and 105 girls), aged between three and 15 years and suffering from recurrent abdominal pain, were seen in general practice in Thamesmead during a seven-year period. Only five were found to have possible organic causes for the pain. Comparison with a control group showed that the close relatives of children with pain consulted doctors more often, had had more abdominal complaints and operations, a higher rate of psychiatric illness and referral, and more known marital problems. Relations between mothers and children with recurrent pain were often unstable and inconsistent. The clinical picture was unhelpful and investigation unproductive.Recurrent abdominal pain in childhood is often a reflection of family disorder, and assessment of the state of the family should precede decisions on management.
J R Coll Gen Pract 1978 Dec
PMID:Recurrent abdominal pain in childhood. 55 75

(1) The failure of ;Slow-K' tablets to disintegrate prevents rapid release but allows them to be trapped by their bulk in the intestine.(2) Two cases are reported. In the first the tablet was trapped in a caecal diverticulum and the patient developed an abcess. In the second, abdominal pain developed which subsided when ;Slow-K' was stopped. Later ;Slow-K' was again started and the patient developed dysphagia.(3) The possibility of abdominal complications with this treatment should be remembered.(4) Effervescent KC1 preparations may replace ;Slow-K' but KC1 supplementation may be necessary only in cardiac disease.
J R Coll Gen Pract 1976 Aug
PMID:Complications of "slow-K" therapy. 96 9

A 15-year old Black teenager came to a clinic at the University of Alabama's School of Medicine in Tuscaloosa requesting oral contraceptives (OCs). The physical examination indicated that she was in good health and the physician prescribed an OC (1 mg norethindrone and .035 mg ethinyl estradiol). 21 months later she returned complaining of yellow eyes for 3 weeks. The oral mucosa was also jaundiced. She had considerably high levels of bilirubin and alkaline phosphatase. She had no hepatitis virus antibodies. 5 months later she returned for the physical examination required to renew the OC prescription. She did not have jaundice at this time. 10 months later she complained of malaise and muscular pain. Her alkaline phosphatase level was high, but her bilirubin level was normal. She had mild hepatosplenomegaly without focal defects. After reviewing her medical records, the physician diagnosed intrahepatic cholestasis and discontinued her OC prescription. Liver function tests were normal within 3 months. 14 months later, she returned complaining of malaise and reported taking OCs obtained at another clinic 3 months earlier. The physician advised her about the complications of OCs and about other contraceptive methods. The same physician also examined a 32-year-old Black woman who had intermittent epigastric and right-upper quadrant abdominal pain for 2 weeks. Eating worsened the pain, which lasted for up to 15 minutes. She had used an OC for 12 years. Ultrasound revealed a 4.2 cm hypoechoic mass in the left upper lobe of the liver. The physician discontinued the OCs. The tumor regressed over 12 months. Active liver disease is a contraindication to OC use. Women who had cholestatic jaundice while pregnant or have first degree relatives with cholestatic jaundice of pregnancy should not use OCs. Physicians may introduce OCs to closely monitored women with a history of liver disease whose liver function tests are normal. Women with a family history of biliary excretion defects should not use OCs.
J Gen Intern Med
PMID:Hepatobiliary complications of oral contraceptives. 133 97

A series of 25 patients referred for psychiatric consultation with nonspecific abdominal pain (NSAP) are compared with a prospectively admitted series who were not referred. The referred patients had a longer duration of pain and also had high levels of psychiatric illness. The referred patients had more life events associated with the onset of their pain than controls. Inquiry about previous psychiatric history, childhood abuse, and a symptom model would increase the detection of NSAP patients who require psychiatric evaluation. Outcome after recommended treatment is also addressed.
Gen Hosp Psychiatry 1991 Jan
PMID:Psychogenic abdominal pain. 199 16

Two cases of vivax malaria which presented atypically as abdominal pain are described. They highlight the need to consider malaria in the differential diagnosis of any acute febrile illness in a patient returning from an endemic malarial area.
J R Coll Gen Pract 1989 Jun
PMID:Indigestion or infection? Unusual presentations of malaria in general practice. 255 21

The evaluation of ambulatory patients with dyspepsia frequently includes upper gastrointestinal radiographs (UGIs), a practice of unproven value in low-risk patients. To assess an alternative management strategy without UGIs, 28 patients with upper abdominal pain seen in an adult medical walk-in practice were treated with high-dose antacid therapy for three weeks. The clinical course on antacid therapy was good; 68% of patients reported substantial improvement. Initial requests for UGIs were high among both patients and physicians. Following empiric antacid therapy, requests for UGIs fell from 68% to 32% for patients (p = 0.05) and from 71% to 21% for physicians (p = 0.001). No serious complications were detected after 18 months of follow up. Direct medical charges were reduced by 37%. Empiric antacid therapy for patients at low risk for serious disease relieves dyspepsia and reduces both patient and physician requests for UGIs.
J Gen Intern Med
PMID:Empiric antacids and reassurance for acute dyspepsia. 377 78

An audit of 150 consecutive cases of abdominal pain presenting to an urban teaching practice between October 1983 and May 1984 was performed. The median duration of pain prior to presentation was two days. Females predominated in all age groups.Eighty-nine per cent of these patients were managed entirely in the practice and of these, 52 per cent were managed with reassurance and advice alone, while 48 per cent also received a prescription. Only 15 per cent of patients were investigated in any way by the practice. Of the 17 patients (11 per cent) referred, nine were referred as emergencies and eight were admitted that day. However, there were only three true surgical emergencies in the entire series (one appendicitis, one intussusception and one fulminating pancreatitis).
J R Coll Gen Pract 1985 May
PMID:Audit of abdominal pain in general practice. 402 Jul 46


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