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

The authors describe a perplexing clinical picture in which an important factor for diagnosing the lesion in the gall-bladder was hyperselective arteriography of the coeliac trunk, and more especially the hepatic artery. The association of a truc septum in the gall-bladder, without gall-stones, and of another digestive tube lesion, megadolicho-sigmoid and diverticulosis of the sigmoid, would appear to be an extremely rare entity, and this has been the cause of the pain reported by the patient over many years. The cholecystectomy performed appears to be the right choice, and the most effective therapeutic procedure.
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PMID:[Anatomical and clinical features of a case of gall-bladder abnormality. Results of arteriographic and micro-angiographic studies (author's transl)]. 22 67

Diverticular disease of the colon can be divided into 1) a prediverticular state similar to spastic colon syndrome, 2) colon diverticulosis without symptoms, 3) chronic symptomatic diverticular disease with pain and stool irregularities and possible attacks with acute colicky pain and 4) acute diverticular disease with possible obstruction, fistula, and perforation and also bleeding. A diet rich in plant fibers is indicated in spastic colon syndrome, chronic diverticular disease and in patients after attacks of acute diverticular disease. A conservative and waiting policy is also indicated in acute diverticulitis and in bleeding.
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PMID:[Clinical findings and conservative therapy in diverticular disease of the colon]. 40 2

Diverticular disease of the appendix involves about 1 per cent of all appendices removed. Considering the large number, the subject appears to have been neglected in medical literature. Since the symptomatology is similar to that of appendicits and diverticula are frequently very small, they could go unnoticed. A comparison of 30 cases of diverticular disease and 30 cases of acute appendicitis reveals a few fine differences. The patients with diverticular disease are at least a decade older, the duration of pain in these patients is longer, and the diverticula and appendix may or may not be inflamed.
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PMID:Diverticular disease of the appendix. 40 91

Diverticular disease is very common among elderly members of "Western, civilized" communities. The aetiopathogenesis is unknown, but may be related to diet and raised intracolonic pressure. Patients with diverticulosis are usually asymptomatic, but those with diverticulitis (which implies inflammation) often present with pain, pyrexia and changes in bowel habit. Careful differential diagnosis is necessary to permit appropriate treatment (medical or surgical), and to detect and treat potentially dangerous complications (abscess, peritonitis, haemorrhage, stenosis, fistula).
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PMID:The diagnosis and management of diverticular disease. 69 22

Treatment of asymptomatic diverticulosis is geared to the prevention of constipation, with vigilance for possible signs of complications. A bulky stool decreases colonic intraluminal pressures, probably lessening pain and the chance of development of new diverticula. Increased stool weight may be achieved by the addition of vegetables, fruits, and cereals (bran) to the diet. Foods with undigestible residues should be avoided. When dietary manipulations are not well tolerated, hydrophilic bulk laxatives are a useful alternative. Treatment of acute attacks consists of bowel rest and administration of intravenous fluids and antibiotics. Side effects of anticholinergics may outweigh their questionable usefulness. Nonabsorable oral sulfonamides have little or no place in the treatment of the acute attack (peridiverticulitis).
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PMID:Medical therapy of colonic diverticular disease. 79 40

A patient over 40 years of age who complains of lower abdominal pain, constipation or diarrhea or both, and increased flatulence should be suspected of having diverticulosis. When pain becomes more severe and persistent, diverticulitis must be considered. Diagnosis depends on roentgen demonstration of the presence of diverticula. Sigmoidoscopy and barium enema study are essential to exclude coexisting disease but in diverticulitis may need to be postponed until severe local and systemic signs of inflammation have subsided. A number of diseases can simulate diverticulitis, and differential diagnosis may present considerable difficulty. Irritable colon syndrome and acute appendicitis may be indistinguishable clinically from diverticulitis. Differentiation from carcinoma is usually not difficult, but exclusion of coexistent carcinoma may be impossible except by resection. Ulcerative colitis is also easily distinguished except when, rarely, it coexists. Crohn's disease of the colon is less easily differentiated, especially in patients over 40, in whom the two diseases often coexist. Other colonic diseases, such as ischemic colitis, and pelvic inflammatory diseases usually show characteristic features which make them readily distinguishable from diverticulitis.
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PMID:Diagnosis and differential diagnosis of colonic diverticulitis. 103 35

From 1966 to 1990, 226 consecutive patients were operated on electively for diverticular disease of the sigmoid colon. The indications for surgery were colovesical fistula or suspicion of residual abscess, existence of two or more previous attacks of acute inflammation, existence of chronic symptoms and suspicion of colonic carcinoma. Colonic resection with primary anastomosis was performed in 217 patients with a covering colostomy in 1 case only. The Hartmann procedure was performed in 9 patients with extension of the lesions to the rectum and/or high operative risk. One or more abscesses were found by the surgeon or the pathologist in 50 p. cent of the patients. There were no postoperative deaths, no clinical anastomotic leakages. Long-term results were evaluated for the patients operated on before 1987, with a follow-up from 2 to 22 years. 85 p. cent of the patients had no more symptoms, 11 p. cent complained of persistent symptoms and 3% had recurrent attacks of pain and fever. Colonic barium enema is the best examination for diverticulitis and chronic abscesses. Surgical treatment is easier for abscesses located within the colonic wall and mesentery, than for extracolic abscesses with local peritonitis. Correlations between preoperative symptoms and operative findings are often not good. The good results obtained in 82 p. cent of the patients operated on for chronic symptoms suggest that chronic symptoms should be part of the indications for elective surgery. The low incidence (3 p. cent) of recurrent attacks of pain and fever is in favour of a resection limited to the sigmoid colon even when diffuse colonic diverticula are present.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Sigmoid diverticular diseases: surgical treatment]. 151 69

Two kinds of acquired diverticular disease were identified. The more common variety presented with pain, bowel symptoms or fistulae, and the less common with bleeding. The former patients rarely had a history of bleeding and among the latter pain and bowel symptoms were uncommon. In contrast to the few, chiefly sigmoid, diverticular often found in the former group, barium enemas of those presenting with bleeding usually showed densely packed and extensive diverticula. Even where there was no history suggesting perforation or evidence of it at operation, specimens resected for the more common form of diverticular disease invariably showed histological evidence of previous perforation. There was no histological evidence of previous perforation in those specimens resected for bleeding. This retrospective clinical, radiological and histological study supported the idea that there are two kinds of diverticular disease, one associated with perforation and its sequelae, the other associated with bleeding.
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PMID:Two kinds of diverticular disease. 186 55

From 1966 to 1990, 226 consecutive patients were operated on electively for diverticular disease of the sigmoid colon. The indications for surgery were colovesical fistula or suspicion of residual abscess, existence of two or more previous attacks of acute inflammation, existence of chronic symptoms and suspicion of colonic carcinoma. Colonic resection with primary anastomosis was performed in 217 patients with a covering colostomy in 1 case only. The Hartmann procedure was performed in 9 patients with extension of the lesions to the rectum and/or high operative risk. One or more abscesses were found by the surgeon or the pathologist in 50% of the patients. There were no postoperative deaths, no clinical anastomotic leakages. Long-term results were evaluated for the patients operated on before 1987, with a follow-up from 2 to 22 years. 85% of the patients had no more symptoms, 11% complained of persistent symptoms and 3% had recurrent attacks of pain and fever. Colonic barium enema is the best examination for diverticulitis and chronic abscesses. Surgical treatment is easier for abscesses located within the colonic wall and mesentery, than for extracolic abscesses with local peritonitis. Correlations between preoperative symptoms and operative findings are often not good. The good results obtained in 82% of the patients operated on for chronic symptoms suggest that chronic symptoms should be part of the indications for elective surgery. The low incidence (3%) of recurrent attacks of pain and fever is in favour of a resection limited to the sigmoid colon even when diffuse colonic diverticula are present.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Diverticular sigmoiditis: surgical treatment]. 180 98

The results of pressure recording in patients with irritable bowel syndrome, diverticulosis and diverticulosis with pain were compared with the results in control subjects. The motility showed variable higher values in patients with irritable bowel syndrome. The motility was clearly higher in patients with diverticulosis and in patients with diverticulosis with pain. The patients with irritable bowel syndrome were younger than the patients in the two groups with diverticulosis. These findings are consistent with the hypothesis that the irritable bowel syndrome is an aetiologic factor in diverticulosis.
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PMID:[Motility of the sigmoid in irritable bowel syndrome and colonic diverticulosis]. 237 31


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