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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

An early upper gastrointestinal series may be carried out on a routine basis after recovery of the postoperative ileus and makes it possible to confirm the good quality of the anastomoses or, by contrast, reveal a benign fistula. Under some circumstances, it may be carried out very early following the development of postoperative complications: pain, fever, respiratory, circulatory and renal insufficiency or in the presence of abnormal discharge from the drains. It then shows whether this complication is due to an oesophagomediastinal or pleural fistula.
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PMID:[The value of early routine radiological examination following esophagectomy for carcinoma of the lower third of the esophagus]. 2 89

Of 112 000 patients undergoing surgery between 1952 and 1973, 67 had a primary tumor of the small intestine. 22 patients had a benign tumor, 8 a carcinoid, 21 carcinoma and 15 sarcoma. Benign tumors were more frequent in the duodenum and ileum, carcinoids in the terminal ileum and carcinomas in the duodenum and jejunum. Sarcomas were found equally in all parts of the small intestine. The most common symptom for all types of the tumor was variable pain in the abdomen. Loss of weight occurred only in patients with carcinomas and sarcomas; heavy intestinal blood loss was most common in patients with benign tumors. Benign tumors often show invagination, while sarcomas cause occlusive ileus or perforation. All duodenal tumors show heavy intestinal bleeding but hematemesis is rare. Emergency surgery was necessary in 42% of patients with benign tumors or sarcoma and in 30% of patients with carcinoma. Five-year survival in patients with benign tumors is excellent (100%). Compared to this, five-year survival in patients with carcinoma, sarcoma or carcinoids is only 15%.
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PMID:[Complications in primary tumors of the small intestine]. 16 32

Spinal epidural abscess is seldom encountered in children and rarely occurs in the absence of spinal pain. A case is described in which a child with a thoracic epidural abscess presented with abdominal rather than spinal pain. Thoracolumbar radicular inflammation and visceroparietal reflexes initiated by a s'spinal ileus' probably produced the symptoms and signs of acute intra-abdominal disease. Consideration of intraspinal disease is advisable in all cases of acute abdomen which exhibit atypical features.
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PMID:Spinal epidural abscess presenting as acute abdomen in a child. 42 Sep 67

This is a case report on a rare intrapartum complication consisting of a jejunogastric invagination 17 years after gastrectomy. The clinical systoms such as pain and tender mass in the epigastric region as well as vomiting are similar to an ileus. Immediate interdepartmental consultation is essential because of the very high mortality rate in case of diagnostic failure. Several possible reasons for the invagination are being discussed. The increased intraabdominal pressure during labor is most probably responsible for this life threatening event.
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PMID:[Intrapartal retrograde jejunogastric invagination after gastrectomy]. 68 58

A gastroduodenal combination preparation was introduced at a deliberately high dosage into a clinical treatment schema. A marked improvement of the subjective symptoms already appeared after a short treatment in hospital, pain in particular being rapidly affected. Younger patients tolerated the preparation excellently, older ones had a marked sedation. Because of the danger of concealment, stenoses in the region of the gastrointestinal tract, ileus and preileus are particular contraindications. The dosage of 3 X 3 to 3 X 4 dragees should be reserved for hospital treatment. The dosage of 3 X 1 dragee for ambulant practice and also for prolonged therapy (ca. 6-8 weeks) is unobjectionable, reference being made to possible initial tiredness and disturbances of accomodation.
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PMID:[Clinical treatment of inflammatory and benign ulcerous diseases of the stomach and duodenum with a new combination preparation (Aci-Tensilan) (author's transl)]. 81 94

A report is given in a case of appendicitis after delivery in childbed. This was the third case of appendicitis within 17 657 deliveries in the gestation of the district hospital in Sangerhausen in the period from 1960 to 1975. The chronic relapsed appendicitis produced a paralytic Ileus. By using correspondent measures (infusional therapy, appendectomy, adhesion solutions) the patient could be cured without any complications. The patient feeled a Douglas-touch of pain that extended especially to the right. This was the only symptom that was noticed by the patient besides the Ileus that had been clinical well defined and secured with the help of x-ray photo.
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PMID:[Ileus due to appendicitis in the puerperium]. 98 90

Initial examination and therapy, and the avoidance of maltreatment are emphasized. Gastric decompression is of prime importance, after which no compound should be administered via stomach tube. Where large amounts of high starch grains are fed, primary acute gastric dilatation must be differentiated from that secondary to small bowel dilatation, by immediate gastric intubation and irrigation of the cardia with lidocaine. If cessation of pain and improvement of peristalsis and general attitude follow, the former state may be assumed. If pain persists and peristalsis does not improve markedly, one should assume small bowel displacement. Rectal examination is helpful in initial evaluation: impactions, inguinal herniation and ileocaecal intussusception may be diagnosed and small bowel displacement suspected. Palpation of one or more distended loops of bowel in the ventral middle third of the abdomen indicates small bowel displacement or ileus and flaccid distension. Distinction by rectal palpation alone is difficult. Palpation of the gas-distended apex of the caecum in the middle third of the abdomen is virtually pathognomonic for 180 degrees rotation of the large bowel. Abdominal paracentesis yielding true sanguineous effusion indicates a necrotizing segment of the bowel. If negative, such a segment is absent, or there is an infarcted segment, not yet damaged to the point of leaching whole blood, or the necrotizing segment is outside the peritoneal cavity, i.e., in the thorax, intussuscepted into the caecum, or herniated into the inguinal canal. Recurrent colics frequently may be due to verminous arteritis but the relationship to diet should be investigated. Recurrent colics after grain ingestion with occult blood in the faeces may be due to ulcers; such cases respond well to grain withdrawal. The advantages and disadvantages of phenothiazine-derived tranquillizers are discussed. They are contra-indicated if there is any evidence of circulating volume insufficiency but are benefical in many instances through improved peripheral perfusion of organs provided circulating volume is adequate, i.e., early in acute abdominal disease prior to development of circulatory insufficiency. They should not be administered if immediate surgery is contemplated because of hypotensive effects. The administration of oral antibiotics (Neomycin) early in the course of the disease is encouraged. This is contra-indicated if the horse is already toxic, when it should receive parenteral antibiotics, preferably chloromycetin. Tetracyclines may predispose to the later development of salmonella diarrhoea. Absolute analgesia should be provided; our preference is the magnesium sulphate-chloral hydrate solutions. Administration of mineral oil is desirable in initiation of peristalsis, depression of Gram-negative overgrowth and softening of impactioning obstructions but nothing should be administered per os if the stomach has required decompression.
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PMID:Monitoring and evaluating the physiological changes in the horse with acute abdominal disease. 117 34

A 75-year-old black man came to the emergency room because of nausea, vomiting, abdominal pain, and distension and obstipation. An abdominal radiograph revealed a sigmoid volvulus. This was nonoperatively reduced in the emergency room. Following a mechanical and antibiotic bowel preparation, the patient underwent elective exploration. We report, for the first time, operative treatment of sigmoid volvulus with a laparoscopic-assisted sigmoid colectomy and primary anastomosis. Because of dense fibrous scarring of the sigmoid mesentery produced by chronic mesosigmoiditis, the redundant sigmoid was exteriorized and resected extracorporeally. A stapled, side-to-side, functional end-to-end anastomosis was constructed. The patient experienced little postoperative pain and virtually no postoperative ileus. We believe that laparoscopic-assisted sigmoid resection may offer distinct advantages for the treatment of the typically elderly, debilitated patient in whom sigmoid volvulus develops. Furthermore, because of the characteristic mesosigmoiditis associated with sigmoid volvulus, we suspect that exteriorization and extracorporeal resection may prove the easiest and most rapid laparoscopic approach to this disease.
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PMID:Laparoscopic-assisted sigmoid colectomy for sigmoid volvulus. 134 64

Recently, laparoscopic cholecystectomy has become the preferred surgical procedure for removal of the gallbladder. However, many surgeons believe that the safety and efficacy have yet to be proved in the community hospital setting. To address this concern, a retrospective chart review of the initial 271 instances of inpatient laparoscopic cholecystectomy within a community hospital was undertaken. All procedures were performed by 15 general surgeons in private practice and residents in general surgery. Of the 271 patients, 11 were converted to open cholecystectomy. Surgical complications occurred in six of the 260 instances of laparoscopic cholecystectomy (2.3 percent), with only one injury to the common bile duct. Major postoperative complications occurred in 23 patients, including severe postoperative pain (nine patients), prolonged ileus (seven patients), bile leakage (three patients), retained common duct stones (two patients), respiratory failure (one patient) and postoperative myocardial infarction (one patient). The period of hospitalization ranged from one to 64 nights with a median of one night. The operative mortality rate was zero percent. Multivariate analysis identified two factors associated with an increased risk of postoperative complications. Patients 70 years of age or older and patients whose operating times were greater than one hour and 45 minutes were at increased risk for postoperative complications. We believe that these data represent the general outcomes of the laparoscopic procedure in a community hospital setting and lend support to the argument that the procedure can be performed safely and effectively in this setting.
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PMID:Laparoscopic cholecystectomy in a community hospital setting. 138 64

An important breakthrough in the field of general surgery, laparoscopic cholecystectomy (LC) offers significant advantages for patients. Major reasons for the rapid worldwide acceptance of this new surgical procedure is that patients experience reduced postoperative pain, ileus is virtually abolished, and the patient is able to leave the hospital the following day without a major abdominal scar. This appears to respond to patients' desire for less invasive approaches to the treatment of gallstone disease. LC is thus becoming the treatment of choice for symptomatic gallbladder disease. Its rapidly growing popularity is evident in Italy where many centers are offering LC routinely, in alternative to open cholecystectomy. A critical appraisal of this new technology is necessary, in light of recent data from centers presenting results and complications of large series of LCs. Adequate training of surgeons who will perform LC is also becoming a major concern. In this review the authors describe patient evaluation and selection for LC. Effective therapeutic strategies are illustrated, including the central, but nevertheless controversial role of endoscopic retrograde cholangiopancreatography (ERCP) as an approach to common bile duct lithiasis. Currently, LC should be performed in centers with the availability of an endoscopist with expertise in ERCP. Following the success of LC, other minimally invasive techniques will evolve in various surgical specialties. New generations of surgeons will thus have to familiarize with these emerging techniques while maintaining a critical attitude of evaluation.
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PMID:[Laparoscopic cholecystectomy. The beginning of a new era]. 138 84


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