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Query: UMLS:C0017160 (gastroenteritis)
 11,398 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In the period from 1963 to 1975 data were collected on 1,781 isolates of Y. enterocolitica from human infections in Belgium. There was an uneven spread of the cases over the country, but this could simply reflect the distribution and activity of medical laboratories. Serotype 3 dominated (89.2%) followed by serotype 9 (8.6%). Less than 1% of all isolates were from nonenteral sources. Gastroenteritis was the diagnosis in 86.8% of patients, while 10.6% were suffering from an appendicitis-like syndrome. Gastroenteritis had its peak incidence in the under 5 year group, whereas the pseudo-appendicular syndrome was more frequent in the 10--19 years age group. There was a distinct seasonal peak in late autumn. The significant association with Salmonella isolation from the stool of the same patient has been confirmed.
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PMID:Epidemiological and clinical aspects of human Yersinia enterocolitica infections in Belgium. 53 73

A child with signs and symptoms of acute gastroenteritis developed localization of her pain to the right lower quadrant. A clinical diagnosis of appendicitis was made and an inflamed appendix was found at surgery. The postoperative period was marked by high spiking fevers and profuse nonbloody diarrhea. Cultures of the appendix and the stool revealed Salmonella typhimurium. Nontyphoidal Salmonella organisms are a rare cause of acute suppurative appendicitis. Intraoperative cultures of the appendix and peritoneal fluid as well as postoperative cultures of the diarrheal fluid were crucial in elucidating the cause of this patient's unusual course.
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PMID:Salmonella typhimurium appendicitis. 191 41

Five hundred and ninety-four patients were consecutively admitted to an infectious disease unit over a 2-year period with a referral diagnosis of acute gastroenteritis or food poisoning. In 175 (29%) patients, gastrointestinal symptoms were associated with a condition other than gastrointestinal infection. Non-infective gastrointestinal disease was present in 90 patients, systemic infection in 50 and systemic disease in 35. Four illustrative case histories are presented to emphasize the need for a high index of suspicion if diseases such as malaria, septicaemia or appendicitis are not to be missed.
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PMID:Acute gastroenteritis: the need to remember alternative diagnoses. 208 49

Intermittent incomplete intestinal obstruction was proven by sonography in 25 male and 48 female patients with an age range of 10 to 88 years. All of them suffered from intermittent colicky pain, nausea and meteorism followed by liquid stools. Only 52 patients had undergone a total of 69 abdominal operations. The pertinent symptoms could be traced back for 6 months to 10 years (4 +/- 3 years). In 47 patients, intake of bulky food during the last 12 to 48 hours triggered the onset of disorders. The preadmission diagnoses were: incomplete intestinal obstruction (only 21), gastroenteritis (15), biliary colic (13), peptic ulcer (10), renal colic (4), food intoxication (4), appendicitis (3), adnexitis (3). Sonographic findings were: inconstant lumen distension, visible bowel wall movements with contractions of 3 to 6 mm, food bolus, enhanced paradoxical peristalsis, proof of distended and collapsed gut segments, bowel wall edema and free peritoneal fluid. Based on these ultrasonic findings and trend observation, conservative treatment was successfully instituted. All patients were discharged symptom-free with no subsequent attacks for 12 months. 20 patients, subsequently suffering from complete intestinal obstruction after 1 to 3 years, were operated on, comprising 8 cases of intestinal resection, 7 cases of adhesiolysis and intestinal tube splinting, 3 cases of band dissection and 2 cases of palliative bypass procedures. The diagnostic accuracy of abdominal ultrasonography is clearly demonstrated by the fact, that 11 of these patients with intermittent incomplete intestinal obstruction and now suffering from complete obstruction had no previous abdominal surgery.
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PMID:[Intermittent incomplete ileus of the small intestine. Sonographic diagnosis and trends]. 217 61

The incidence of perforated appendicitis has remained high in the infant and young child resulting in substantial morbidity. The purpose of the present study was to investigate the factors contributing to the high perforation rate seen in this age group. A retrospective analysis was done on 77 patients under the age of seven who underwent appendectomy for appendicitis. The perforation rate was 72.7 per cent. Duration of pain correlated with patient age and perforation rate. Under the age of five, only 17 per cent had symptoms for less than 36 hours. Children with symptoms that lasted longer than 48 hours had a perforation rate of 98 per cent. Associated illnesses including respiratory infections, otitis media, and gastroenteritis were common in both simple and perforated appendicitis, often leading to a delay in diagnosis. Of patients with perforation, 36 per cent were seen at least once by the primary physician and discharged. The keys to the diagnosis of appendicitis in this young age group were history and physical exam. Right lower quadrant findings were present in 95 per cent of patients with simple appendicitis and 71 per cent of patients with perforation. The primary-care physician and consulting surgeon have crucial roles in diagnosing the disease early in its course.
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PMID:Factors responsible for the high perforation rate seen in early childhood appendicitis. 280 84

Delay in appendectomy occurs from failure to contact a physician, or from a physician's failure to make a proper diagnosis. In our study delay was due to physician error in 32 of 422 children who had appendectomy. Symptoms consistent with appendicitis were documented on the initial visit in each case, but 22 patients had a history of previous similar pain or recent viral illness to confuse the diagnosis. Misdiagnosis was responsible for the delay in 14 cases (gastroenteritis in ten and urinary tract infection in four). Antibiotics given before proper diagnosis in 22 instances increased diagnostic difficulty in 20. Late referral is increasing, perhaps because of a perceived innocuous nature of appendicitis. Complicated appendicitis was found in 26 children (81%), compared with 38% of the total experience. Their hospital stay averaged nine days, as opposed to 6.6 days in the nondelayed group. Failure of resolution of symptoms after therapy begins mandates reassessment to avoid progression of this common surgical disease.
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PMID:Delayed diagnosis in pediatric appendicitis. 333 98

A prospective study was conducted on 344 children aged from 3 months to 16 years with acute appendicitis. Most children presented with typical features of acute appendicitis (70%) or peritonitis (28%). Atypical presentation was uncommon and occurred only in seven young children, masquerading as intestinal obstruction, gastroenteritis or urinary tract infection. Prolonged delay in surgery was associated with a rise in incidence of late appendicitis (gangrenous and perforated appendicitis). This rise was especially marked 37 h after onset of symptoms. The main causes of delay were inability of the parents and primary care medical practitioners to recognize the disease early. Surgeons contributed very little to the delay. High risk factors for postappendectomy sepsis were young children under 6 years old, late appendicitis, obese patients, inferior systemic antibiotic regimes and inexperienced surgeons. Young children had high postoperative sepsis mainly because of the high incidence of late appendicitis due to their inability to express their symptoms properly. They were not especially prone to postappendectomy sepsis; they had the same degree of appendicitis compared with older children. Measures to decrease the postappendectomy morbidity are suggested.
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PMID:Acute appendicitis in children. 343 36

The diagnosis of adenocarcinoma of the colon in juvenile subjects usually poses a difficult problem due to its clinical presentation, which usually mimics disorders that are commonly found in children. This article presents the case of a 13-year-old boy who was admitted 2 weeks earlier to another hospital, where his condition was not recognized. He presented with abdominal signs and symptoms suggestive of diseases such as gastroenteritis, appendicitis, and intussusception which are common in this age group. The x-ray film showed dilated loops of small bowel and the proximal portion of colon, suggesting intestinal obstruction. At surgery, a 4 X 4 cm tumor in the transverse colon was resected. Microscopically, the lesion showed moderately differentiated adenocarcinoma with foci of mucin production.
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PMID:Adenocarcinoma of colon in a child. 379 19

In a two-year-study, the primary feces of all children with gastroenteritis or acute abdominal symptoms were checked for the presence of Campylobacter jejuni (C. j.) even when there was no diarrhea. C. j. could be isolated 19 times from among 974 fecal samples. The most frequent admission diagnosis after gastroenteritis was the suspicion of appendicitis. In the forefront of the clinical picture was abdominal pain, which radiated into the right lower abdomen especially in children of school age, and which was frequently not accompanied by diarrhea. Apart from a leucocytosis with left shift, the laboratory results obtained revealed no parameters which could be utilized for early diagnosis of C. j. infection. 16 out of 19 isolated strains were sensitive to erythromycin. It is still uncertain whether the clinical picture under discussion can indeed be mitigated by administration of erythromycin, and for this reason controlled prospective studies would be desirable.
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PMID:[Campylobacter jejuni infections in children]. 389 53

The pathology of the alimentary tracts of nine patients dying of Salmonella typhimurium infection is reviewed. Two patients had previous gastric operations, supporting previous reports that such patients are more susceptible to food poisoning. Four had no parietal (oxyntic) cells in the gastric mucosa, suggesting hypo- or anacidity. Only one had acute gastritis. None had acute enteritis, but in half of the patients, subtle histological changes suggested an 'enteropathy'. Acute diffuse colitis with abundant crypt abscesses, without stromal abscesses in the lamina propria, was the most constant finding and reparative features started very early, and occurred in later deaths. Under ideal circumstances this crypt abscess is readily distinguished from that of idiopathic ulcerative colitis, but can be confused with the crypt abscess of acute bacillary (sonne) dysentery. While the florid colonic changes may have settled in the late deaths, active inflammation is commonly present in the appendix mucosa on histology. The pathology of the alimentary tract in S typhimurium infection differs from that of S typhi and S paratyphi infections. There is little evidence of gastroenteritis, although subtle changes occur in the stomach and small intestine. The features are those of acute diffuse colitis with histological appendicitis, distinguishable from idiopathic ulcerative colitis.
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PMID:Pathology of the alimentary tract in Salmonella typhimurium food poisoning. 389 61


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