Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 43-year-old woman was admitted on October 6, 1987 with the chief complaint of fecaluria, pneumaturia and miction pain. She had been diagnosed as Crohn's disease in March, 1987. Urinalysis revealed numerous leucocytes, and streptococcus faecium was identified by urine culture. Contrast film of small intestines showed ileovesical fistula arising from terminal ileum. Cystoscopy revealed a papillary tumor-like appearance at the dome of the bladder. An operation was performed on November 9 under the diagnosis of ileovesical fistula complicating Crohn's disease. It was found that ileal region formed a hard adhesion to the bladder wall. Partial resection of the ileum and bladder was performed. Ileovesical fistula was found in the adhesion. Histological diagnosis of the affected ileum was Crohn's disease, showing noncaseating granuloma with the multinucleated giant cells. This case is the first report of female urological complication of the Crohn's disease in the Japanese literature.
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PMID:[Ileovesical fistula complicating Crohn's disease: a case report]. 267 84

Emphysematous cystitis constitutes an uncommon clinical radiological entity. (Approximately 160 cases in the literature). We offer five cases of emphysematous cystitis, all of which occurred in women aged 60-80 (X = 74.2). All of them except one proved to be known diabetics and the glycemia figures at the time of being attended were above the limits of normality. In no case was pneumaturia observed, and the main symptoms displayed were those of the cystitis type together with pain in the hypogastrium and macroscopic hematuria. Simple abdomen radiology was the diagnosis procedure in all cases. The treatment applied permitted the favourable evolution and resolution of the process.
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PMID:[Emphysematous cystitis]. 268 70

Review of 31 cases of enterovesical fistulas treated at the Departments of Urology and General Surgery during the period 1970-1982. In 20 cases (64.5%) the underlying cause was a carcinoma (overall colorectal neoplasm) and in 7 cases (23%) it was an inflammatory disease. Gouverneur's syndrome (suprapubic pain, frequency, dysuria, urinary pain and tenesmus) was present in 17 patients (54.8%). Pneumaturia and fecaluria were present in 18 and rectal micturition in only 5. The diagnosis was based on cystograms in 66.6% of the patients. Other explorations oriented us towards the location of the fistula but only confirmed it in a low percentage (10-30%). The treatment undertaken varied in each case depending on the etiology and the patient's condition: medical (3%), derivative and palliative surgery (23%) and radical surgery (68%).
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PMID:Review of 31 vesicointestinal fistulas: diagnosis and management. 394 96

A 20-year-old man with Crohn's disease was seen as an outpatient for pain in the left hip and gait disturbance. Initially, arthritis of the hip was suspected, because of the absence of fever or abdominal abnormalities. Two weeks later, fever, malaise, and pneumaturia developed and urine culture grew Escherichia coli. Laparotomy revealed a large occult retroperitoneal abscess on the left side, which had been irritating the psoas muscle. Surgical drainage effected complete recovery of hip function. The abscess in this patient had a very unusual presentation and was diagnosed chiefly through a high index of suspicion after a careful physical examination.
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PMID:Hip pain in patient with Crohn's disease. Occult retroperitoneal abscess as cause. 636 83

Enterovesical fistula is a relatively uncommon complication of colorectal and pelvic malignancies, diverticulitis, inflammatory bowel disease, radiotherapy, and trauma in Asian countries. A case of vesico-ileosigmoidal fistula and a literature review of this disease in Japan are presented. A 70-yr-old male was referred with complaints of urinary pain and pneumaturia. On admission, urinary tract infection and pneumaturia were presented. A barium enema demonstrated multiple diverticulum in his sigmoid colon and the passage of contrast medium into the bladder and ileum. Under the diagnosis of vesico-ileosigmoidal fistula due to suspected diverticulitis of the sigmoid colon, sigmoidectomy and partial resection of the ileum with partial cystectomy were performed. The histopathology revealed diverticulosis of the sigmoid colon with diverticulitis and development of a vesico-ileosigmoidal fistula. No malignant findings were observed. Until the year 2000, a total of 173 cases of vesico-sigmoidal fistula caused by diverticulitis had been reported in Japan. Pneumaturia and fecaluria are the most common types, presenting symptoms in 63% of the cases. Computed tomography, with a sensitivity of 40% to 100%, is the most commonly used diagnostic study. For patients with vesico-sigmoidal fistula, resection of the diseased sigmoid colon and partial cystectomy with primary anastomosis are the safest and most acceptable procedures, leading to the best results.
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PMID:Vesico-ileosigmoidal fistula caused by diverticulitis: report of a case and literature review in Japan. 1280 35

Emphysematous cystitis (EC) and emphysematous myositis (EM) are rare disorders and concurrent occurrence of both in a patient with type 2 diabetes has not been reported previously. We report a patient who presented with pneumaturia and later with pain in thigh and diagnosed of both concurrently.
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PMID:Co-occurrence of emphysematous cystitis and emphysematous myositis in type 2 diabetes. 1657 70

A 91-year-old woman with type 2 diabetes presented at the emergency ward subconscious with lower abdominal swelling. Evaluation revealed dehydration and hyperglycaemia, and abdominal x-ray showed an air space surrounding a severely swollen bladder. After excluding enterovesical fistulae, the patient was diagnosed with emphysematous cystitis. Treatment for urinary retention, antibiotic treatment and control of the diabetes mellitus resulted in a rapid recovery. A second patient, a 65-year-old woman with a history of recurrent urinary tract infections and urolithiasis, presented with irritative urinary symptoms and pain in the lower abdomen. Explicit inquiry revealed that she also had intermittent pneumaturia. Urethrocystoscopy revealed submucosal bullae, which are a hallmark of emphysematous cystitis. The patient was given intravenous antibiotic therapy. Diabetes mellitus is a risk factor for emphysematous cystitis. The disorder is treated by draining the bladder with an indwelling catheter and intravenous antibiotic therapy, selected according to the urine culture results. In general, orally administered antibiotics are insufficient.
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PMID:[Emphysematous cystitis: from bullae to pneumaturia]. 1836 Nov 95

Colovesical fistula (CVF) resulting from colon diverticulosis is a comparatively rare disease, and neither the diagnosis nor treatment has been established. Our experience with CVF due to sigmoid diverticulitis over a 9-year period was reviewed to clarify the clinical presentation and diagnostic confirmation. Ten patients with CVF were identified in this period, and chief complaints, laboratory findings, presenting symptoms, diagnostic investigations, and subsequent treatments were reviewed. Preoperative urinalysis showing bacteriuria (100%) was the most common presentation, followed by fecaluria (40%), abdominal pain (40%), pneumaturia (30%), hematuria (30%), pain on urination (30%), pollakiuria (10%), and dysuria (10%). The abilities of various preoperative investigations to identify CVF were: computed tomography (CT), 88.9%; magnetic resonance imaging, 40%; cystoscopy, 30%, and gastrografin irrigoscopy, 22.2%. Colonoscopy (0%) was not diagnostic. Bowel resection was performed in nine of ten patients. When inflammation was intense, covering ileostomy was performed, and an omental plasty was placed between the bowel anastomosis and bladder. When CVF is suspected, we recommend CT followed by colonoscopy and cystoscopy as a first-line investigation to rule out malignancy as a cause. Other modalities should only be used if the diagnosis is in doubt or additional information is needed to plan operative management. Primary colic anastomosis appears to be safely performed by applying omental plasty and covering ileostomy.
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PMID:Ten Cases of Colovesical Fistula due to Sigmoid Diverticulitis. 2621 Dec 19

We report here a rare case of urethral fistula and scrotal abscess associated with colovesical fistula due to sigmoid colon cancer. An 84-year-old male was referred to our hospital complaining of macrohematuria, fecaluria, pneumaturia and micturitional pain. Computed tomography (CT) showed colovesical fistula. Other examinations, including colonoscopy and cystoscopy, did not reveal a clear cause for the colovesical fistula. Only an elevated serum level of the tumor marker CA19-9 suggested the possibility of sigmoid colon cancer. Eleven days after hospitalization, bilateral scrotal contents had swollen rapidly to the size of a goose egg. CT suggested urethral fistula with scrotal abscess formation. Drainage of scrotal abscess and colostomy were performed. Intraoperatively, the fistula of the bulbar urethra was revealed. Because increased serum CA19-9 suggested a diagnosis of sigmoid colon cancer, cystectomy and sigmoid colectomy with right nephrectomy were performed. Pathological examination revealed adenocarcinoma of sigmoid colon with bladder invasion. His condition was improved with rehabilitation 6 months after operation.
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PMID:[Urethral Fistula and Scrotal Abscess Associated with Colovesical Fistula Due to the Sigmoid Colon Cancer]. 2649 65

An 82-year-old male with benign prostatic hyperplasia (BPH) who underwent transurethral resection of the prostate (TURP) presented to the hospital with suprapubic pain, abdominal distension, and diarrhea. The physical examination was remarkable for an indwelling Foley's catheter. Diagnostic imaging confirmed the diagnosis of a rectourethral fistula (RUF). The most common presenting symptoms of RUF are pneumaturia, fecaluria, and urine leakage from the rectum, which may present similarly to diarrhea. He lacked the common features of RUF such as pneumaturia and fecaluria, which may be explained by a blockage of the catheter with fecal material. This case represents a rare outcome following a TURP, and it is significant due to the high morbidity associated with RUF. As such, clinicians must suspect a RUF in a post-TURP patient with diarrhea and no other obvious etiology due to the morbidity associated with RUF.
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PMID:Rectourethral Fistula Secondary to Transurethral Resection of the Prostate. 3064 27


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