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

This article discusses the findings of a study of pre-adolescent children to determine if the mode of presentation of appendicitis had changed over the past 10 years, if the incidence of perforations decreased with age, and if diagnosis related groups (DRGs) impacted the length of hospital stay. The charts of 42 children under the age of 12 years who were discharged from two inner-city hospitals with a diagnosis of acute appendicitis from 1980 to 1989 were reviewed. There were 20 blacks and 22 whites, 26 males and 16 females with an average age of 7.31 years (range: 2 to 11 years). Over 95% of patients presented with right lower quadrant pain, 78% with guarding, 80% with a positive psoas sign, 93% with a positive Rovsing's sign, and 65% with rectal tenderness. Over 85% of patients had a history of nausea, vomiting, and anorexia. The mean duration of pain was 52.8 hours and the mean temperature was 99.6 degrees F. The mean white blood cell count was 18,176 +/- 4682 for whites versus 14,615 +/- 5459 for blacks. At surgery 15/42 (36%) of patients had a perforation, 11 of whom had positive wound cultures. Escherichia coli was recovered in all 11 of these patients. The average duration of pain in the perforated group was 50.9 hours, and the average age was 7 years. Eleven of these patients had normal bowel sounds on admission. Only 31% of the total cohort had a fecalith identified by pathology. The average postoperative length of stay was 6.5 +/- 2.5 days before the initiation of DRGs and 7.5 +/- 3 days afterward.
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PMID:Appendicitis in children: a continuing clinical challenge. 140 59

This study was applied on 9665 cases between January 1993 and October 1998. Of these, 6985 (72.3%) were urologic patients and 2680 (27.7%) were autopsy cases. The patients having urinary complaint investigated by urine analysis and kidney-ureter-bladder film (KUB), routinely. In all patients who have pathological urine, ultrasonography exam was done and in all patients who established an abnormality on ultrasonography, intravenous pyelography (IVP) was taken, also. We established the horseshoe kidney in 23 of patients (1/304) and in 6 of autopsy cases (1/447) with overall incidence 1/333. There were 21 male and 8 female with horseshoe kidney (male/female = 2.6/1). Abdominal discomfort with lower lumbar pain and Rovsing's sign were seen in 56.5% and in 65.2% of patients respectively. We concluded that horseshoe kidney incidence is almost the same as reported in the literature, although its clinical appearance is higher in our urologic patient population. In the urological out-patient evaluation, at least Rovsing's sign should be applied to all patients with lower lumbar pain with vague abdominal discomfort and an abdominal ultrasonographic exam should be applied, if this sign is positive.
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PMID:The comparison of the incidence of horseshoe kidney in autopsy cases versus urologic patient population. 1050 67