Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0184567 (acute pain)
 3,962 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 27-year-old woman developed acute pain, pallor and feeling of cold in her left arm. She had been a smoker of 15-20 cigarettes daily since the age of 15 years, but had not previously had any serious illness. In addition to contraceptives she had had been taking one to several suppositories containing caffeine and ergotamine tartrate (2 mg) daily against migraine. Angiological examination 5 days after onset of symptoms discovered a weak brachial pulse low in the left upper arm, while ulnar and radial pulses were absent. All other pulses were normally palpable. Colour duplex sonography demonstrated occlusion of the brachial artery which angiographically was due to a 5 cm severe narrowing without thrombus, blood flowing distally via collaterals. No improvement was achieved by local injection of 100,000 IU urokinase, 0.5 mg nitroglycerin, 20 mg tolazoline and a 3-hour infusion of alprostadil. On infusion of 560 ml hydroxyethylstarch over 8 hours, 400 mg naftidrofuryl, therapeutic doses of heparin and abstinence from ergotamine (since admission) the vessel diameter increased by 50% within 23 hours and after a further 24 hours to almost 100% of the comparable arterial segment of the right arm while merely on heparin infusion.
 ...
PMID:[Acute ischemia of an arm as an unusual manifestation of ergotism]. 795 78

Thrombosis of an abdominal aortic aneurysm is a rare devastating complication with an estimated mortality rate of 50%. Simultaneous acute pain, pallor and coldness of the lower limbs, mottling from the level of iliac crests or umbilicus, paraplegia and absence of femoral pulses are all manifestations of a sudden and acute interruption of blood flow through the aneurysmatic aorta. We report a case of an occlusion of an abdominal aortic aneurysm during hospitalization which was not manifested with symptoms of limb ischemia. In this case we feature the rare and unusually "silent" presentation of the event.
 ...
PMID:"Silent" thrombosis of an abdominal aortic aneurysm not producing acute limb ischemia. 2073 87

A 70-year-old woman with osteoporosis fell at home and presented to our emergency department with intense left hip pain. Radiographs revealed a left iliopubic rami fracture and nondisplaced right ischiopubic rami fracture. She was discharged after a 24-hour observation with no clinical changes. Seventy-two hours later, she was readmitted with a painful abdominal mass, progressive oliguria, tachycardia, hypotension, and profuse perspiration with generalized pallor. On physical examination, a painful mass in the hypogastrium and intense inflammation in the thigh and the proximal portion of left knee were found.Emergent multiphase contrast computed tomography revealed a large nonhomogeneous hematoma neighboring the fractured left iliopubic rami, and contrast extravasation indicated arterial bleeding. Selective angiography showed an active hemorrhage from the distal portion of a small branch of the left obturator artery. After embolization of the arterial vessel, the patient was hemodynamically stable. The fracture was rotationally and vertically stable.These fractures are common, especially among the elderly. This type of injury is usually treated conservatively and with active mobilization once the acute pain has subsided. Supraselective embolization after localization of the bleeding vessels by arteriography is recognized as a minimally invasive procedure with excellent outcomes in hemorrhagic complications of pelvic fractures. An apparently benign pubic rami fracture in the setting of hemodynamic instability should raise the suspicion of a corona mortis injury, especially in elderly and anticoagulated patients.
 ...
PMID:Corona mortis artery avulsion due to a stable pubic ramus fracture. 2222 19

A 62-year-old man with diabetes and a history of ischemic coronary disease visited the emergency department complaining of acute pain and swelling of the tongue. Physical examination found subtle swelling and pallor of the right side of the tongue, and he was initially diagnosed with glossitis. However, his symptoms were progressive, and the tongue had sustained serious tissue damage before the correct diagnosis was established. Digital subtraction angiography of the cervical vessels revealed occlusion of the right external carotid artery (ECA) and lingual artery without collateral circulation to the right side of the tongue from the contralateral ECA or ipsilateral vertebral artery (VA). Endovascular revascularization was performed to restore blood flow to the tongue using balloon angioplasty of the proximal segment of the right ECA followed by deployment of a self-expanding stent. Tongue pain subsided shortly after the procedure, and configuration of the tongue returned to normal 4 months after intervention. Tongue infarction is rare and usually associated with systemic vasculitides. Tongue infarction due to unilateral occlusion of the ECA is extremely rare because of the rich collateral circulation to the tongue from the ipsilateral VA and contralateral ECA. Atherothrombotic unilateral occlusion of the ECA should be included in the differential diagnosis of tongue infarction. Revascularization of the occluded ECA is worth attempting despite substantial tissue damage because of the viability of the tongue muscles and the minimal risk of complications in experienced hands.
 ...
PMID:Endovascular revascularization of external carotid artery occlusion causing tongue infarction: case report. 2326 48