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Query: UMLS:C0013395 (dyspepsia)
 4,879 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Many patients with chronic renal failure have dyspeptic symptoms. However, mesenteric panniculitis as a cause of dyspepsia has not been described in this patient group. We report a 78-year-old hemodialysis patient who was admitted because of intractable dyspepsia. Investigations with ultrasonography, endoscopy and barium studies were all inconclusive. Computed tomography of the abdomen demonstrated a large encapsuled soft-tissue mass in the root of mesentery. Percutaneous biopsy confirmed the diagnosis of mesenteric panniculitis. Percutaneous drainage was performed when liquefaction of the mesenteric mass lesion was noted on follow-up computed tomography 1 month later. Improvement of gastrointestinal symptoms occurred soon after drainage of the fluid component of the mesenteric mass. Microbiologic and cytologic studies of the drainage specimens were negative. Follow-up computed tomography 3 months later showed reduction in the size of the mesenteric mass.
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PMID:Mesenteric panniculitis: an unusual cause of dyspepsia in a hemodialysis patient. 1920 22

NICE recommends immediate referral for patients with dyspepsia and significant acute GI bleeding and urgent specialist referral for investigation if any of the following alarm symptoms are present: progressive difficulty swallowing; chronic GI bleeding; unintentional weight loss; persistent vomiting; abdominal mass; iron deficiency anaemia; suspicious findings on barium meal. Patients aged > 55 with unexplained and persistent dyspepsia, despite H. pylori testing and acid suppression therapy, should also be considered for endoscopy, as should those with previous gastric ulcer or surgery, continuing need for NSAIDs or raised risk of gastric cancer. Patients with uninvestigated dyspepsia should be managed by empirical treatment with a PPI or testing for and treating H. pylori if present. Testing by urea breath test, stool antigen test, or locally validated lab-based serology is suggested. H. pylori eradication is usually given as triple therapy, for seven days, involving a PPI, clarithromycin and either amoxicillin or metronidazole. It is important to take a thorough history and to enquire about any medication the patient is taking. Drugs that are common culprits for dyspepsia include: NSAIDs; calcium antagonists; bisphosphonates; steroids; theophyllines; nitrates. NSAIDs can also cause GI bleeding. Absence of dyspepsia in patients taking NSAIDs does not indicate a reduced risk of bleeding. Peptic ulcers fall into three categories: H. pylori associated ulcers; drug-induced ulcers (particularly NSAIDs); and ulcers in H. pylori-negative patients not taking causative medication. H. pylori is associated with both gastric and duodenal ulcer disease but it is in the duodenum where the closest relationship exists. In any 6-12 month period, 20-40% of healthy people, more commonly men, will experience symptoms of heartburn. Oesophageal reflux can progress to more serious disease such as erosive oesophagitis, stricture or Barrett's oesophagus.
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PMID:Managing dyspepsia in primary care. 1993 59

Eradication therapy for H. pylori infected gastritis became the health insurance application in Japan in 2013. It will seem that the conception of "the chronic gastritis" greatly changes from now on in Japan. "The chronic gastritis" will be classified in H. pylori gastritis and functional dyspepsia in the near future. On the other hand, it is expected that the process of the gastric cancer detection survey greatly changes too. It seems that the ABC checkup using the blood will be carried out in place of Barium examination. A decrease in gastric cancer mortality is expected as things mentioned above from now on.
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PMID:[Effect on medical practices after health insurance application for "H. pylori gastritis"]. 2396 84

A 44-year-old man with upper abdominal pain, diarrhea and 25 kg weight loss since 3 months ago was admitted. He had a history of dyspepsia and peptic ulcer disease 4 months before admission. Gastroduodenal endoscopy and upper gastrointestinal series with barium study were done. Biopsies and CT-scan ruled out malignancies. Endoscopy and radiology studies revealed a duodenocolic fistula. He underwent right hemicolectomy, fistula en bloc excision, and distal gastrectomy surgery with gastrojejunostomy and ileocolic anastomosis. Radiologic modalities are necessary before surgery. Surgery is the only curative treatment in benign cases and reconstruction method is dependent on patient's situation.
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PMID:Benign duodenocolic fistula as a complication of peptic ulcer disease. 2543 1

Diaphragmatic herniation is an uncommon complication in the postquirurgic follow of the liver transplant. The associated symptoms are unspecific and may not suggest the correct diagnosis. It may explain why in many patients the diagnosis remains unmade or it is made only after a long interval of time. We present the case of a fifty-seven-year-old male who required an orthotopic liver transplant in 2010 due to a trifocal hepatocarcinoma. In postoperatory follow-up the patient showed alimentary regurgitation, vomiting, and dyspepsia. The diagnosis was made by an oesophagogastroduodenal transit with barium and an abdominal CT scan that showed a left diaphragmatic herniation with the gastric fundus into the thorax. With these findings we decided to perform a programmed surgery. After takedown of adhesions and replacement of the stomach into the upper abdomen, the palm-sized diaphragmatic opening was closed with a synthetic material. The patient's condition remained stable throughout the entire operation. The postoperative course was uneventful and he was discharged at the fifth day after surgery with a normal digestive intake. In a 12-month follow-up the patient shows no symptoms.
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PMID:Left Diaphragmatic Herniation following Orthotopic Liver Transplantation in an Adult. 2606 64

It is commonly believed that young calves should not be fed more than about 2l of milk per meal. If calves are fed beyond this volume, it is said that the capacity of the abomasum may be exceeded and that milk could enter the rumen. This can disturb the microbial flora/fauna of the rumen and increase the risk of indigestion, diarrhoea and reduced growth. The aim of this study was to examine the effect of large milk meals on digestive physiology and behaviour in dairy calves. Six calves (19-23days of age at the beginning of the experiment) were fed 2l of warm whole milk by teat bottle three times per day, which was the recommended Norwegian feeding regime at the time. The calves were given free access to hay, concentrates and water. During three morning feeding sessions, each separated by 48h, all calves were offered larger meals. The offered amounts were calculated according to the within patient 3-level Response Surface Pathway (RSP) design. The milk given on the three test days contained a contrast medium (barium sulphate), and the animals were radiographed before, during and immediately after intake to reveal whether milk entered the rumen. Four out of the six calves drank more than 5l in one meal and the highest voluntary intake was 6.8l in one meal (13.2% of BW). Abdominal radiographs showed that the abomasum has a large ability for distension. Milk in the rumen was not observed in any of the calves, regardless of intake. The behaviour of the calves was observed for 2h after each test session. No behaviour indicating abdominal pain or discomfort was observed regardless of intake. The results indicate that when warm whole milk is administered from a teat bottle, farmers can increase the amount of milk they offer their calves beyond the traditionally recommended portion size without risk of milk entering the rumen. Hence, farmers who want to feed their calves more milk can do so by increasing meal sizes, and not necessarily by introducing an additional meal.
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PMID:The effect of large milk meals on digestive physiology and behaviour in dairy calves. 2663 44

Bariatric surgery is the most effective treatment for morbid obesity. Due to the high volume of weight loss procedures worldwide, the general surgeon will undoubtedly encounter bariatric patients in his or her practice. Liberal use of CT scans, upper endoscopy and barium swallow in this patient population is recommended. Some bariatric complications, such as marginal ulceration and dyspepsia, can be effectively treated non-operatively (e.g., proton pump inhibitors, dietary modification). Failure of conservative management is usually an indication for referral to a bariatric surgery specialist for operative re-intervention. More serious complications, such as perforated marginal ulcer, leak, or bowel obstruction, may require immediate surgical intervention. A high index of suspicion must be maintained for these complications despite "negative" radiographic studies, and diagnostic laparoscopy performed when symptoms fail to improve. Laparoscopic-assisted gastric band complications are usually approached with band deflation and referral to a bariatric surgeon. However, if acute slippage that results in gastric strangulation is suspected, the band should be removed immediately. This manuscript provides a high-level overview of all essential bariatric complications that may be encountered by the acute care surgeon.
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PMID:Essential bariatric emergencies for the acute care surgeon. 2666 88

Background Superior mesenteric artery syndrome (SMAS) results from the compression of the third part of the duodenum between the aorta and the proximal part of the superior mesenteric artery (SMA). Clinical presentation of SMAS is characterized by the dilatation of the proximal part of the third part of the duodenum. SMAS is a rare cause of the upper gastrointestinal system (UGS) obstruction. In this study, we aimed to present our clinical experience in the treatment of five patients with SMAS, which is a rare clinical condition requiring surgery. Patients and methods The retrospective study included five patients who were treated due to SMAS at our clinic between January 2010 and January 2014. Results All the patients were underweight, with a mean BMI of 15.73 (14-16). The clinical symptoms included epigastric pain after food intake, large volume bilious emesis, early satiety, failure to gain weight, indigestion, esophageal reflux, sense of fullness, and persistent weight loss. SMAS was diagnosed using barium meal studies, upper gastrointestinal endoscopy, abdominal ultrasonography, and CT angiography. Four patients underwent duodenojejunostomy and one patient was managed with gastrojejunostomy. No complication was observed during the postoperative period, and all the patients achieved significant improvement in symptoms. Conclusion SMAS is a rare cause of UGS obstruction, and the diagnosis of SMAS is often delayed. SMAS should be suspected in the differential diagnosis of the patients with unsubstantiated symptoms of persistent nausea, emesis, and significant weight loss.
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PMID:Superior mesenteric artery (Wilkie's) syndrome: a rare cause of upper gastrointestinal system obstruction. 2738 94

1. GASTRIC function was studied pre-operatively in 55 patients with primary hyperparathyroidism. In all patients the diagnosis of hyperparathyroidism was proved by the removal of an enlarged parathyroid gland or glands, following which the serum calcium fell to normal or below. 2. Twenty patients (38 per cent) gave a history of dyspepsia. All patients were given a barium meal and 12 (22 per cent) were found to have a duodenal ulcer. Male patients had dyspepsia and/or an ulcer more frequently than female patients. 3. Kay's augmented histamine test was carried out in all patients. Six patients (11 per cent) had achlorhydria, six had hyperchlorhydria (11 per cent), the remaining patients secreting normal amounts of acid. The acid secretion did not differ significantly from that of a group of euparathyroid patients studied under similar circumstances who did not have duodenal ulcer on barium meal. 4. Antigastric-parietal-cell antibodies and antithyroid antibodies were absent in all 20 patients, including five with achlorhydria, tested. 5. Serum gastrin was slightly elevated in three out of 10 patients preoperatively, and there was no consistent change following parathyroidectomy. 6. Although there is a high incidence of dyspepsia and of duodenal ulcer in patients with primary hyperparathyroidism they do not tend to have increased acid secretion.
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PMID:Gastric function in primary hyperparathyroidism in man. 2751 61

Distal oesophageal spasm is a rare condition that affects the motility of the oesophagus. It can be diagnosed by highresolution oesophageal manometry and the diagnosis is supported by other modalities such as barium swallow and esophagogastroduodenoscopy examinations. Treatment options include pharmacological therapy, endoscopy and surgical interventions. We described a case of distal oesophageal spasm in an elderly patient who presented with chronic dyspepsia.
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PMID:It's not just a heartburn and reflux disease: a case report of distal oesophageal spasm and review of literature. 3192 83


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