Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0740577 (acute abdominal pain)
 1,982 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Meckel's diverticulum occurs in 2% of the population and may present at any age. Its management, when found incidentally at laparotomy, remains controversial, particularly in the pediatric population. From 1970 to 1989, a Meckel's diverticulum was discovered in 164 children at laparotomy. There were 120 boys and 44 girls with a mean age of 5.2 years (range, 0 to 18 years). Forty-seven cases were asymptomatic, representing an incidental finding at laparotomy, 25 were resected, and ectopic gastric mucosa was present in 7 specimens (28%). Three postoperative deaths (6%) that were not related to the resection and 2 complications (4%) (postoperative leak and wound infection) occurred in this group. Of the 117 symptomatic patients, 49 (42%) presented with bowel obstruction, 45 (38%) had rectal bleeding, 16 (14%) had diverticulitis, and 7 (6%) had umbilical pathology. Volvulus (20) and intussusception (19) were the most common causes of obstruction. Predisposing factors for bowel obstruction were fibrous bands to umbilicus or mesentery (37%) and ectopic mucosa (35%). Severe painless rectal bleeding occurred in 45 patients, 30 of whom (67%) required blood transfusion. A nuclear medicine Meckel scan was positive in 32 of 37 patients (85%). Contrast studies were not diagnostic; colonoscopy and gastroscopy ruled out other causes of bleeding. Patients with diverticulitis (16) presented with acute abdominal pain compatible with appendicitis. In the symptomatic group, ectopic mucosa was present in 61% of the resected specimens. Gastric (88%), pancreatic (7%), and gastric with pancreatic (3%) were the most common ectopic tissue. Postoperative morbidity and mortality for symptomatic patients was 8.5% and 0%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Meckel's diverticulum in children: a 20-year review. 181 59

An 18 year old girl presented with acute abdominal pain and a calcified opacity in the pelvis. She proved to have a Meckel's diverticulum which had a secondary diverticulum at its apex, containing a stone. Meckel's stones are uncommon and diverticula of a Meckel's diverticulum exceedingly rare. This is only the second recorded case of such a diverticulum containing a stone, and the first to describe a calcified stone in this location.
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PMID:Diverticulum of a Meckel's diverticulum containing a stone. 192 63

Meckel's diverticulum is a rare, but serious cause of acute abdominal pain. The prevalence of Meckel's diverticulum is 2% and lifetime risk of illness in a diverticulum is 4.2%. The risk declines with age and approaches zero after the age of 70. Morbidity after resection of symptomatic Meckel's diverticulum is 11.1-17.6% with 6.0-7.5% mortality. The morbidity rate for resection of incidentally discovered diverticulum is 1.2-8.9%. Symptoms and complications are related to age. Below the age of one year the most prevalent complication is gastrointestinal obstruction. Later in childhood the most dominating complication is peptic ulcer with serious gastrointestinal bleeding, while various kinds of gastrointestinal obstruction and diverticulitis are most prevalent in adults. The treatment of symptomatic Meckel's diverticulum is resection. However, the treatment of incidentally discovered Meckel's diverticulum is a subject of dispute. After a thorough study of the literature we conclude that resection should be the routine for all incidentally discovered Meckel's diverticulums in persons younger than 40. After this age resection should be reserved for patients with palpable stigmata of heterotopic tissue, diverticulums of some length and the presence of omphaloenteric- or omphalodiverticulare chords.
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PMID:[Meckel's diverticulum. Symptoms, diagnosis and treatment]. 204 55

The authors present the case of a 59 year-old patient with numerous stratified stercoliths within a large Meckel's diverticulum. An abdominal X-ray without contrast material, done while the patient was in acute abdominal pain showed a liquid-density mass. The diagnosis was considered because of the presence, within the mass, of a fluid level and several unusual calcifications. Ultrasound ruled out a gall-bladder or urinary origin. Surgical excision of the mass confirmed the diagnosis; the X-ray of the specimen allowed a comparison with the previous abdominal X-rays. The authors review the literature on the subject and suggest a gamut for the differential diagnosis of stratified calcifications of the abdomen.
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PMID:[The secret of the pyramids ... or calcifications in Meckel's diverticulum]. 361 18

The authors report what they believe is the first report in the English literature of acute inflammation of ectopic pancreatic tissue in a Meckel's diverticulum. A 29-year-old man presented with acute abdominal pain and a clinical diagnosis of acute appendicitis was made. Laparotomy revealed a normal appendix and a Meckel's diverticulum with gross inflammation at the distal end. Microscopic examination showed acute inflammation limited to ectopic pancreatic tissue in the wall of the diverticulum. Fat necrosis was present. The possible pathophysiologic mechanisms are discussed.
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PMID:Acute inflammation of pancreatic tissue in a Meckel's diverticulum. 713 21

A quality audit was performed of the case records of 1313 children admitted with acute abdominal pain over a three year period under the care of paediatric surgeons at the Princess Margaret Hospital for Children, Perth. Fifty-four per cent (n = 714) of the patients were discharged without surgical intervention; in this group the most frequent (70%, n = 503) diagnosis was non-specific abdominal pain (NSAP). Of those children having surgery, 74% (n = 443) had appendicitis proven on histopathology; the remaining appendices (n = 134) were reported as normal and no other surgical cause for the patients symptoms were identified. Only 3.7% (n = 22) of children having surgery had another surgical cause for their pain. Of this group, 11 had adnexal pathology, eight had complications of a Meckel's diverticulum and three had torsion of the omentum. There were no deaths in this series, and 39 patients (3%) had wound infections. Based on these results, only 35% of children referred to a surgeon with abdominal pain will actually require surgical intervention, although as a consequence of concern over clinical status an additional 10% will have a laparotomy with normal findings.
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PMID:Acute abdominal pain in children: an analysis of admissions over a three year period. 888 58

Meckel's diverticulum is the most common anomaly of the gastrointestinal tract. Neoplasms are extremely rare. We report a case of carcinoid tumor of Meckel's diverticulum in a patient with acute abdominal pain. So far, 111 cases have been reported. Review of the literature reveals that carcinoids are the most common malignant tumors of Meckel's diverticulum. Two thirds of the patients remain asymptomatic. Metastases are seen in 25% at diagnosis. The probability of metastases depends on the size of the primary tumor. Because of the early metastases rate even in small tumors, aggressive surgical management is justified.
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PMID:[Carcinoid tumor in Meckel's diverticulum: case presentation and review of the literature]. 928 35

The use of diagnostic laparoscopy in acute abdominal pain, especially when patients have been admitted for acute pain in the lower abdominal quadrants, improves the accuracy of diagnosis and leads to improvements in treatment procedures. A case is reported of a 24-year-old woman admitted under suspicion of appendicitis. The appendix was found to be normal, and a perforation caused by a fishbone was discovered in a Meckel's diverticulum. The diverticulum was resected by a combined laparoscopic and open procedure. Diagnostic laparoscopy should be performed routinely in cases of acute abdominal pain in the lower quadrants of suspected appendiceal origin to avoid overlooking other causes of the symptoms.
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PMID:Fishbone perforation through a Meckel's diverticulum: a rare laparoscopic diagnosis in acute abdominal pain. 1048 31

Two unconnected cases of type E botulism involving a 19-year-old woman and a 9-year-old child are described. The hospital courses of their illness were similar and included initial acute abdominal pain accompanied by progressive neurological impairment. Both patients were suspected of having appendicitis and underwent laparotomy, during which voluminous Meckel's diverticula were resected. Unusual neurotoxigenic Clostridium butyricum strains that produced botulinum-like toxin type E were isolated from the feces of the patients. These isolates were genotypically and phenotypically identical to other neurotoxigenic C. butyricum strains discovered in Italy in 1985-1986. No cytotoxic activity of the strains that might explain the associated gastrointestinal symptoms was demonstrated. The clinical picture of the illness and the persistence of neurotoxigenic clostridia in the feces of these patients suggested a colonization of the large intestine, with in vivo toxin production. The possibility that Meckel's diverticulum may predispose to intestinal toxemia botulism may warrant further investigation.
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PMID:Intestinal toxemia botulism in two young people, caused by Clostridium butyricum type E. 1058 83

Seventy-two cases of Meckel's diverticulum were treated surgically in recent four years. There were 61 boys and 11 girls with a mean age of 5.2 years. Of the 65 symptomatic patients, 31(43%) had rectal bleeding, 16(23%) suffered from bowel obstruction and 17(24%) peritonitis. Patients with diverticulitis(8 cases) had acute abdominal pain in the periumbilical region or in the right lower quadrant compatible with appendicitis. Ectopic mucosa was found in 47 cases(65.3%). Gastric(36 cases) and pancreatic(11 cases) were the most common ectopic tissues. A nuclear medicine Meckel scan was positive in 26 of 31 patients(84%). It is emphasized that 99mmTcO4- scintiphoto is more specific in diagnosis of the Meckel's diverticulum. The best choice of the surgery is resection of the diverticulum and end-to-end intestinal anastomosis.
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PMID:[Meckel's diverticulum and its complications in children]. 1080 69


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