Sample records for abdominal pain bloody

  1. Abdominal pain

    MedlinePLUS

    Stomach pain; Pain - abdomen; Belly ache; Abdominal cramps; Bellyache; Stomachache ... Almost everyone has pain in the abdomen at some point. Most of the time, it is not serious. How bad your pain is does not always reflect the seriousness ...

  2. Pain and bloody ear discharge in a returning traveler.

    PubMed

    LaCourse, Sylvia M; Martinez, Raquel M; Spach, David H; Fang, Ferric C

    2015-03-01

    Cochliomyia hominivorax, the New World screwworm, was a serious livestock pest in the southern United States until the 1960s, when it was successfully eradicated by the release of sterile male flies. It remains endemic in parts of the Caribbean and South America, and there is concern that climate change may extend its geographic distribution. Cochliomyia hominivorax is voracious and can cause extensive damage to soft tissue and bone. We describe the case of a 26-year-old traveler who presented with otalgia and bloody otorrhea after returning from a vacation in the Dominican Republic, where exposure to screwworm flies most likely occurred during a nap on the beach. The causative agent was recognized by its characteristic larval anatomy, which includes pigmented dorsal tracheal trunks and posterior spiracles with an open peritreme. PMID:25510727

  3. Pathology Case Study: Abdominal Pain

    NSDL National Science Digital Library

    LaTulippe, Steven

    This is a case study presented by the University of Pittsburgh Department of Pathology in which a 65-year-old man is complaining of abdominal pain. Visitors are given the radiology, gross and microscopic descriptions, flow cytometry, and molecular diagnostics, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in hematopathology.

  4. Pathology Case Study: Abdominal Pain

    NSDL National Science Digital Library

    Nine, Jeff S.

    This is a case study presented by the University of Pittsburgh Department of Pathology in which a 72-year-old man has abdominal pain, anorexia, and weight loss but no significant past medical history. Visitors are given both the microscopic and gross descriptions, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in autopsy pathology.

  5. Abdominal pain - children under age 12

    MedlinePLUS

    Stomach pain in children; Pain - abdomen - children; Abdominal cramps in children; Belly ache in children ... belly Has had a recent injury to the abdomen Is having trouble breathing Call your doctor if ...

  6. Abdominal Mondor's disease presenting as acute abdominal pain.

    PubMed

    Cervellin, Gianfranco; Creta, Michele; Riva, Michele; Di Comite, Vincenzo; Buttarelli, Lorenzo; Lippi, Giuseppe

    2013-08-01

    We describe here the case of 41 yrs old male patient, who was admitted to the emergency department complaining for abdominal pain lasting for two days. The patient self-reported a history of idiopathic deep vein thrombosis five yrs before the visit. A subcutaneous cordlike induration, tender and painful, was clearly palpable in the left lower abdominal quadrant. Routine blood tests did not reveal any substantial abnormality, except increased D-dimer concentration. Ultrasound evaluation of the abdominal wall revealed diffuse thrombosis of the left superficial inferior epigastric vein, involving several small tributaries branches, extended until 1.5 cm from the confluence with the common femoral vein, which was finally classified as an atypical case of Abdominal Mondor's disease. Complete thrombophilia screening was negative. The patient was discharged with warfarin therapy 48 hours from admission. At 30 days follow-up, the patient self-reported a nearly complete recovery. PMID:24165464

  7. Thoracic meningioma masquerading as chronic abdominal pain.

    PubMed

    Lyons, Mark; Windgassen, Elizabeth; Kinney, Carolyn; Johnson, Daniel; Birch, Barry; Boucher, Orland

    2012-01-01

    Chronic abdominal pain without a structural or metabolic gastroenterological etiology can be extremely challenging to diagnose. Patients presenting with an associated radicular pattern of pain may alert the clinician to a possible structural neurological cause of the symptoms. We present the case of a 70-year-old woman who presented to our institution with an 18-month history of right upper quadrant abdominal pain. She had no associated symptoms or provoking factors. She underwent an extensive gastroenterology evaluation, including colonoscopy that was unrevealing. Ultrasound demonstrated gallstones and she was evaluated for cholecystectomy. She subsequently developed right costal margin pain. Her symptoms remained stable over the course of the next year. Follow-up general surgical evaluation was still unconvincing that the gallstones were the etiology of her symptoms. A thoracic spinal MR demonstrated a large intradural extramedullary mass at T8. The patient's neurological exam was normal. She underwent a thoracic laminectomy and resection of meningioma with intraoperative electrophysiological monitoring. Her abdominal pain resolved. Patients can present with months to years of elusive abdominal symptoms only to be eventually found to be harboring an undiagnosed spinal tumor. We discuss the case and review the literature reports of spinal tumors masquerading as chronic abdominal pain. PMID:22665009

  8. Case of cytomegalovirus colitis in an immunocompetent patient: a rare cause of abdominal pain and diarrhea in the elderly

    PubMed Central

    Harano, Yumi; Kotajima, Lisa; Arioka, Hiroko

    2015-01-01

    Cytomegalovirus (CMV) colitis usually occurs in immunocompromised patients after undergoing organ transplantation or chemotherapy. We report the case of a 60-year-old immunocompetent Japanese woman who presented with abdominal pain and bloody diarrhea. She was initially diagnosed as having ischemic colitis with pseudomembranous colitis on the basis of her symptoms, Clostridium difficile antigen positivity, and colonoscopic findings, which showed ulcer formation from the sigmoid colon to rectum. In spite of bowel rest and administration of metronidazole, her symptoms did not improve. On follow-up colonoscopy, ulcerations remained unchanged. Biopsy of the ulceration revealed CMV-infected cells leading to a diagnosis of CMV colitis. CMV colitis is a rare but possible differential diagnosis in immunocompetent patients. We recommend endoscopic biopsy in a case of refractory abdominal pain and bloody diarrhea.

  9. Treating abdominal pain in young people.

    PubMed

    McVeigh, Grace; Cardwell, Pauline

    2015-02-01

    A common complaint in children, abdominal pain can be clinically challenging for healthcare professionals to diagnose and treat. Accurate assessment and thorough investigations, combined with the measurement and monitoring of vital signs, are essential to eliminate any underlying conditions. Self-reporting tools can be used to aid communication with children, who may have difficulties articulating their thoughts and feelings. This article refers to a case study to discuss the care of children who present to emergency departments (EDs) with abdominal pain. It suggests that children's nursing students can be valuable assets in busy EDs because they have the knowledge and skills required to care for young people. PMID:25659796

  10. Chronic abdominal pain--a radiological solution.

    PubMed

    Jain, Paresh; Gandhi, Vidhyachandra; Marar, Shaji; Nagral, Aabha; Nagral, Sanjay

    2010-01-01

    Chronic mesenteric ischaemia is not an uncommon disorder. It is associated with high morbidity and mortality. It presents with chronic abdominal pain and the diagnosis is often missed because of nonspecific clinical findings and limitations of diagnostic studies. Although surgery has been considered to be the mainstay of treatment, it is associated with significant morbidity. We report two cases of chronic mesenteric ischaemia managed effectively with endovascular therapy with no morbidity and good long term pain relief. PMID:20649103

  11. Abdominal Pain, Long-Term

    MedlinePLUS

    ... or do you alternate between loose and hard bowel movements? Yes Your pain may be from IRRITABLE BOWEL ... 6. Do you have soft or diarrhea-like bowel movements many times throughout the day and mucus or ...

  12. Functional bowel disorders and functional abdominal pain

    Microsoft Academic Search

    W G Thompson; G F Longstreth; D A Drossman; K W Heaton; E J Irvine; S A Müller-Lissner

    1999-01-01

    The Rome diagnostic criteria for the functional bowel disorders and functional abdominal pain are used widely in research and practice. A committee consensus approach, including criticism from multinational expert reviewers, was used to revise the diagnostic criteria and update diagnosis and treatment recommendations, based on research results. The terminology was clarified and the diagnostic criteria and management recommendations were revised.

  13. Pathology Case Study: Progressive Abdominal / Pelvic Pain

    NSDL National Science Digital Library

    McFadden, Kathryn

    This is a case study presented by the University of Pittsburgh Department of Pathology in which a woman presented with progressively worsening abdominal/pelvic pain over a period of 6 weeks. She experienced minor intermittent pain. Visitors can view both gross and microscopic descriptions, including images, and have the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to introduce or test students of pathology.

  14. Exercise-related transient abdominal pain (ETAP).

    PubMed

    Morton, Darren; Callister, Robin

    2015-01-01

    Exercise-related transient abdominal pain (ETAP), commonly referred to as 'stitch', is an ailment well known in many sporting activities. It is especially prevalent in activities that involve repetitive torso movement with the torso in an extended position, such as running and horse riding. Approximately 70% of runners report experiencing the pain in the past year and in a single running event approximately one in five participants can be expected to suffer the condition. ETAP is a localized pain that is most common in the lateral aspects of the mid abdomen along the costal border, although it may occur in any region of the abdomen. It may also be related to shoulder tip pain, which is the referred site from tissue innervated by the phrenic nerve. ETAP tends to be sharp or stabbing when severe, and cramping, aching, or pulling when less intense. The condition is exacerbated by the postprandial state, with hypertonic beverages being particularly provocative. ETAP is most common in the young but is unrelated to sex or body type. Well trained athletes are not immune from the condition, although they may experience it less frequently. Several theories have been presented to explain the mechanism responsible for the pain, including ischemia of the diaphragm; stress on the supportive visceral ligaments that attach the abdominal organs to the diaphragm; gastrointestinal ischemia or distension; cramping of the abdominal musculature; ischemic pain resulting from compression of the celiac artery by the median arcuate ligament; aggravation of the spinal nerves; and irritation of the parietal peritoneum. Of these theories, irritation of the parietal peritoneum best explains the features of ETAP; however, further investigations are required. Strategies for managing the pain are largely anecdotal, especially given that its etiology remains to be fully elucidated. Commonly purported prevention strategies include avoiding large volumes of food and beverages for at least 2 hours prior to exercise, especially hypertonic compounds; improving posture, especially in the thoracic region; and supporting the abdominal organs by improving core strength or wearing a supportive broad belt. Techniques for gaining relief from the pain during an episode are equivocal. This article presents a contemporary understanding of ETAP, which historically has received little research attention but over the past 15 years has been more carefully studied. PMID:25178498

  15. Eosinophilic Jejunitis Presenting as Intractable Abdominal Pain

    PubMed Central

    Mungan, Zeynel; Attila, Tan; Kapran, Yersu; Tokatli, Ilyas Pinar; Unal, Zeynep

    2014-01-01

    Eosinophilic gastroenteritis is an uncommon disease characterized by eosinophilic infiltration of the gastrointestinal tract. The clinical manifestations are related to the layer(s) and extent of the bowel involved. In this paper, we present a case of intractable abdominal pain caused by jejunal submucosal eosinophilic infiltration without mucosal involvement, diagnosed by deep endoscopic biopsies. The patient was successfully treated with steroids without need for surgery for diagnosis or therapy. PMID:25565932

  16. An easily overlooked cause of abdominal pain

    PubMed Central

    Bennett, Kyle; Rettew, Andrew; Shaikh, Bilal; Supplee, Suzanne; Alweis, Richard

    2014-01-01

    A 63 year old female presented to the emergency department with a several month history of intermittent right upper quadrant abdominal pain, early satiety with loss of appetite, and an unintentional weight loss of 8. She underwent a battery of tests that returned negative and subsequently sent for Computed tomographic angiography (CTA) of the abdomen revealing luminal stenosis of the proximal 1 cm of the celiac axis estimating 90% occlusion and a patent SMA and IMA with, typical for median arcuate ligament syndrome. The symptoms, diagnosis, and treatment options are discussed. PMID:25432644

  17. If I Had - A Child with Abdominal Pain

    MedlinePLUS Videos and Cool Tools

    ... Post-Surgical Pain, Turmeric a Potential Diabetes Treatment, C-Sections Performed in Record Numbers Doctors Should Promote ... Abdominal Pain - Dr. Sanjeev Dutta, MD, MA, FRSC(C), FACS In the Spotlight - Dr. Howard Hodis, MD ...

  18. Midgut malrotation with chronic abdominal pain.

    PubMed

    Wanjari, Anil K; Deshmukh, Arjun J; Tayde, Parimal S; Lonkar, Yashwant

    2012-04-01

    Abnormalities in midgut rotation occur during the physiological herniation of midgut between the 5(th) and 10(th) week of gestation. The most significant abnormality is narrow small bowel mesentery which is prone to volvulus. This occurs most frequently in the neonatal period, less commonly midgut malrotation presents in adulthood with either acute volvulus or chronic abdominal symptoms. It is the latter group that represents a diagnostic challenge. We report a case of a 17-year-old male patient who presented with 10-year history of nonspecific gastro-intestinal symptoms. After extensive investigation the patient was diagnosed with midgut malrotation following computed tomography of abdomen. The patient was treated with a laparoscopic Ladd's procedure and at 3 months he was gaining weight and had stopped vomiting. A laparoscopic Ladd's procedure is an acceptable alternative to the open technique in treating symptomatic malrotation in adults. Midgut malrotation is a rare congenital anomaly which may present as chronic abdominal pain. Abdominal CT is helpful for diagnosis. PMID:22536565

  19. FREQUENCY OF DISACCHARIDASE DEFICIENCIES IN CHILDHOOD CHRONIC ABDOMINAL PAIN

    Technology Transfer Automated Retrieval System (TEKTRAN)

    BACKGROUND: Recurrent abdominal pain and discomfort are common symptoms in children. Childhood chronic abdominal pain (CCAP) is a poorly understood condition, which occasionally requires EGD. Endoscopy is performed to search for etiologies such as peptic ulcer disease. Lactose and sucrase-isomaltas...

  20. [Surgical management of acute abdominal pain in children].

    PubMed

    Scheye, T

    1999-01-01

    Acute abdominal pain is one of the most frequent causes of admission to an emergency department of a children's hospital. It continues to be a clinical challenge and the diagnosis viewed with the most apprehension is acute appendicitis. The clinical examination must be meticulous and repeated in order to assess the evolution of the abdominal syndrome and to adapt the paraclinic examinations. All the abdominal pains are not surgical but justify an admission for observation in pediatric surgical department. PMID:10642638

  1. Psychosocial stress and abdominal pain in adolescents.

    PubMed

    Shapiro, Michael A; Nguyen, Mathew L

    2010-06-01

    Children and adolescents may express psychiatric symptoms via somatic complaints. Likewise, children with chronic somatic illnesses are likely to experience psychiatric sequelae. We report three cases of adolescents who were admitted to general paediatrics services for abdominal pain and/or nausea and vomiting with a negative medical workup. In each case, a clear psychosocial stressor was evident. It is possible that somatic symptoms without clear medical causes may reflect psychosocial stress, but it is difficult to discern whether the psychosocial issues preceded the somatic complaints or were a result of them. Making an accurate diagnosis is difficult, and broaching such a subject with patients and their families is a delicate matter. More research is needed to determine appropriate screening tools for identifying cases where psychosocial stress may play a relevant role in symptom presentation, as well as potential treatment modalities for such cases. PMID:22477924

  2. Early Postoperative Pain After Keyless Abdominal Rope-Lifting Surgery

    PubMed Central

    Hüsey?no?lu, Ürfettin; Ç?çek, Melek

    2015-01-01

    Background and Objectives: Keyless abdominal rope-lifting surgery is a novel, gasless, single-incision laparoscopic surgical technique. In this study we aimed to compare the postoperative pain from keyless abdominal rope-lifting surgery with carbon dioxide laparoscopy performed for benign ovarian cysts. Methods: During a 20-month period, 77 women underwent surgery for a benign ovarian cyst. Keyless abdominal rope-lifting surgery and conventional carbon dioxide laparoscopy techniques were used for the operations in 32 women and 45 women, respectively. The 2 operative techniques were compared with regard to demographic characteristics; preoperative, intraoperative, and postoperative data including early postoperative pain scores; and frequency of shoulder pain and analgesic requirements. Results: Data regarding demographic characteristics, preoperative findings, cyst diameters and rupture rates, intra-abdominal adhesions, intraoperative blood loss, and postoperative hospital stay did not differ between groups (P > .05). However, the mean operative and abdominal access times were significantly longer in the keyless abdominal rope-lifting surgery group (P < .05). Visual analog scale pain scores at initially and at the second, fourth, and 24th hours of the postoperative period were significantly lower in the keyless abdominal rope-lifting surgery group (P < .05). Similarly, keyless abdominal rope-lifting surgery caused significantly less shoulder pain and additional analgesic use (P < .05). Conclusion: Keyless abdominal rope-lifting surgery seems to cause less pain in the management of benign ovarian cysts in comparison with conventional carbon dioxide laparoscopy.

  3. Kikuchi-Fujimoto's disease with abdominal pain due to intra-abdominal lymphadenitis.

    PubMed

    Noda, Ayako; Kenzaka, Tsuneaki; Sakatani, Takashi; Kajii, Eiji

    2014-01-01

    A 29-year-old woman was admitted to our hospital with fever and abdominal pain. Abdominal echogram and CT revealed intra-abdominal lymphadenopathy. Seven days after the onset, she developed cervical lymphadenitis. Kikuchi-Fujimoto's disease (KFD) was diagnosed on cervical lymph node biopsy. Although KFD with intra-abdominal lymphadenopathy is rare, it should be considered in young adults with intra-abdominal lymphadenitis. Because KFD is a benign, self-limiting disease, we suggest the use of a minimally invasive method of diagnosis such as superficial lymph node biopsy. PMID:24667948

  4. Diagnostic yield of oesophagogastroduodenoscopy in children with abdominal pain

    PubMed Central

    THAKKAR, K.; CHEN, L.; TATEVIAN, N.; SHULMAN, R. J.; MCDUFFIE, A.; TSOU, M.; GILGER, M. A.; EL-SERAG, H. B.

    2010-01-01

    SUMMARY Background Abdominal pain is the most common indication for oesophagogastroduodenoscopy (OGD) in children. However, existing studies examining the diagnostic outcomes of OGD in children with abdominal pain are limited. Aim To examine the diagnostic yield of OGD with biopsy in the evaluation of abdominal pain and to describe the endoscopic and histological findings in patients undergoing OGD for abdominal pain of unclear aetiology. Methods We performed a retrospective cross-sectional cohort study in children under 18 years of age who had OGD for the primary indication of abdominal pain, at Texas Children's Hospital and Children's Hospital of The King's Daughters from 1 January 2002 to 30 June 2005. Results Overall, OGD was diagnostic in 454 (38.1%) of the 1191 procedures, including reflux oesophagitis (23%, n = 271), Helicobacter pylori infections (5%, n = 55), peptic ulcers (3%, n = 32), eosinophilic oesophagitis (2%, n = 25), celiac disease (1%, n = 9) and Crohn's disease (0.5%, n = 7). Male gender, older age, elevated C-reactive protein and vomiting were associated with increased diagnostic yield. Conclusions Our findings suggest that OGD is valuable for the evaluation of chronic abdominal pain in children, with a diagnostic yield of 38%. The majority of alarm symptoms and routine laboratory tests are not significantly associated with diagnostic yield. PMID:19573168

  5. Support Vector Machine Diagnosis of Acute Abdominal Pain

    NASA Astrophysics Data System (ADS)

    Björnsdotter, Malin; Nalin, Kajsa; Hansson, Lars-Erik; Malmgren, Helge

    This study explores the feasibility of a decision-support system for patients seeking care for acute abdominal pain, and, specifically the diagnosis of acute diverticulitis. We used a linear support vector machine (SVM) to separate diverticulitis from all other reported cases of abdominal pain and from the important differential diagnosis non-specific abdominal pain (NSAP). On a database containing 3337 patients, the SVM obtained results comparable to those of the doctors in separating diverticulitis or NSAP from the remaining diseases. The distinction between diverticulitis and NSAP was, however, substantially improved by the SVM. For this patient group, the doctors achieved a sensitivity of 0.714 and a specificity of 0.963. When adjusted to the physicians' results, the SVM sensitivity/specificity was higher at 0.714/0.985 and 0.786/0.963 respectively. Age was found as the most important discriminative variable, closely followed by C-reactive protein level and lower left side pain.

  6. Diagnostic imaging of acute abdominal pain in adults.

    PubMed

    Cartwright, Sarah L; Knudson, Mark P

    2015-04-01

    Acute abdominal pain is a common presentation in the outpatient setting and can represent conditions ranging from benign to life-threatening. If the patient history, physical examination, and laboratory testing do not identify an underlying cause of pain and if serious pathology remains a clinical concern, diagnostic imaging is indicated. The American College of Radiology has developed clinical guidelines, the Appropriateness Criteria, based on the location of abdominal pain to help physicians choose the most appropriate imaging study. Ultrasonography is the initial imaging test of choice for patients presenting with right upper quadrant pain. Computed tomography (CT) is recommended for evaluating right or left lower quadrant pain. Conventional radiography has limited diagnostic value in the assessment of most patients with abdominal pain. The widespread use of CT raises concerns about patient exposure to ionizing radiation. Strategies to reduce exposure are currently being studied, such as using ultrasonography as an initial study for suspected appendicitis before obtaining CT and using low-dose CT rather than standard-dose CT. Magnetic resonance imaging is another emerging technique for the evaluation of abdominal pain that avoids ionizing radiation. PMID:25884745

  7. Altered rectal sensory response induced by balloon distention in patients with functional abdominal pain syndrome

    Microsoft Academic Search

    Tsukasa Nozu; Miwako Kudaira

    2009-01-01

    BACKGROUND: Functional abdominal pain syndrome (FAPS) has chronic unexplained abdominal pain and is similar to the psychiatric diagnosis of somatoform pain disorder. A patient with irritable bowel syndrome (IBS) also has chronic unexplained abdominal pain, and rectal hypersensitivity is observed in a majority of the patients. However, no reports have evaluated the visceral sensory function of FAPS precisely. We aimed

  8. Plain abdominal radiography in acute abdominal pain; past, present, and future

    PubMed Central

    Gans, Sarah L; Stoker, Jaap; Boermeester, Marja A

    2012-01-01

    Several studies have demonstrated that a diagnosis based solely on a patient’s medical history, physical examination, and laboratory tests is not reliable enough, despite the fact that these aspects are essential parts of the workup of a patient presenting with acute abdominal pain. Traditionally, imaging workup starts with abdominal radiography. However, numerous studies have demonstrated low sensitivity and accuracy for plain abdominal radiography in the evaluation of acute abdominal pain as well as various specific diseases such as perforated viscus, bowel obstruction, ingested foreign body, and ureteral stones. Computed tomography, and in particular computed tomography after negative ultrasonography, provides a better workup than plain abdominal radiography alone. The benefits of computed tomography lie in decision-making for management, planning of a surgical strategy, and possibly even avoidance of negative laparotomies. Based on abundant available evidence, major advances in diagnostic imaging, and changes in the management of certain diseases, we can conclude that there is no place for plain abdominal radiography in the workup of adult patients with acute abdominal pain presenting in the emergency department in current practice. PMID:22807640

  9. [Chronic low back pain and abdominal aortic aneurysm].

    PubMed

    Zúñiga Cedó, E; Vico Besó, L

    2013-10-01

    Abdominal aortic aneurysm has a population prevalence of 2-5% and mortality in case of rupture of 80%. Up to 91% of cases is accompanied with low back pain, so it is important to include aortic aneurysm in the differential diagnosis of chronic low back pain. Low back pain is one of the most frequent reasons for consultions in Services Emergency Hospital Emergency and Primary Care Services, with an estimated 80% of population having spinal pain at some point in their lives, with 90% of them having a benign course. PMID:24095169

  10. Hereditary angioneurotic oedema: an unusual cause of recurring abdominal pain.

    PubMed

    Feller, E J; Spiro, H M; Katz, L A

    1970-12-01

    Two patients with hereditary angioneurotic oedema, a condition characterized by repeated episodes of abdominal pain and oedema, and by an absence of complement-1 esterase inhibitor activity in the plasma are presented in detail. Both underwent multiple surgical procedures before the diagnosis was established. Abdominal pain is often the presenting complaint, and although a complete history will usually lead to the proper diagnosis, cases in which the family history is not clear can present a diagnostic dilemma. Characteristic radiological demonstration of localized intestinal oedema will only be obtained if studies are performed early during the acute attack. PMID:5511819

  11. Abdominal pain secondary to a sacral perineural cyst

    Microsoft Academic Search

    Curtis W Slipman; Atul L Bhat; Sarjoo M Bhagia; Zacharia Issac; Russell V Gilchrist; David A Lenrow

    2003-01-01

    BACKGROUND CONTEXT: Perineural cysts are commonly found in the sacral region and are incidently discovered on imaging studies performed for the evaluation of low back and\\/or leg pain.PURPOSE: To report on a patient presenting with abdominal pain secondary to a large sacral perineural cyst.STUDY DESIGN\\/SETTING: Case report.METHODS\\/PATIENT SAMPLE: A 47-year-old woman was referred to a specialized multidisciplinary spine center with

  12. [13-Year old boy with abdominal pain].

    PubMed

    Thomassen, Irene; Klinkhamer, Paul J J M; van de Poll, Marcel C G

    2012-01-01

    A 13-year old boy presents with pain in the lower right abdomen, showing clinical signs of appendicitis. During McBurney' incision an appendix sana was seen. Histologic examination showed penetrating enterobiasis. This was treated with mebendazol. PMID:22551758

  13. Investigating vomiting and/or bloody diarrhoea in Campylobacter jejuni infection.

    PubMed

    Gillespie, Iain A; O'brien, Sarah J; Frost, Jennifer A; Tam, Clarence; Tompkins, David; Neal, Keith R; Syed, Qutub; Farthing, Michael J G

    2006-06-01

    Campylobacter jejuni infection frequently presents as acute enteritis with diarrhoea, malaise, fever and abdominal pain. Vomiting and bloody diarrhoea are reported less frequently. To investigate potential host, micro-organism or environmental factors that might explain the different clinical presentations, the features of laboratory-confirmed Campylobacter jejuni cases presenting with vomiting and/or bloody diarrhoea were compared with cases who did not report either clinical manifestation. Single variable analysis and logistic regression were employed. Explanatory variables included food, water and environmental risks. Cases who reported vomiting and/or bloody diarrhoea tended to suffer a longer illness and were more likely to require hospital admission. Independent risks identified were being a child, female gender, consumption of poultry other than chicken, pre-packed sandwiches and sausages, and reported engineering work or problems with drinking-water supply. A dose-response relationship with vomiting and/or bloody diarrhoea and increasing daily consumption of unboiled tap water was observed also. Vomiting and/or bloody diarrhoea characterized the more severe end of the disease spectrum and might relate to host susceptibility and/or infective dose. The role of unboiled tap water as a potential source of C. jejuni infection in England and Wales requires further investigation. PMID:16687593

  14. Recurrent Abdominal Pain, Anxiety, and Depression in Primary Care

    Microsoft Academic Search

    David A. Brent; John V. Campo; Mary Ehmann; Sarah Altman; Amanda Lucas

    2010-01-01

    ABSTRACT. Objective. The prevalence of psychiatric disorder in children and adolescents with functional re- current abdominal pain (RAP) is unknown. Our aim was to determine whether RAP is associated with psychiatric symptoms and disorders, anxious temperament, and functional impairment in pediatric primary care. Methods. Children and adolescents who were 8 to 15 years of age, inclusive, and presented with RAP

  15. EGD IN CHILDREN WITH ABDOMINAL PAIN: A SYSTEMATIC REVIEW

    Technology Transfer Automated Retrieval System (TEKTRAN)

    BACKGROUND: We performed a systematic review to examine the diagnostic yield (endoscopic and histologic) of esophagogastroduodenoscopy (EGD) for the evaluation of abdominal pain of unclear etiology in children. We also examined the effect of EGD on change in treatment, quality of life, change in abd...

  16. [A 15-year old boy with abdominal pain].

    PubMed

    Raats, Jelle W; Donker, Jeroen M W; van der Laan, Lijckle

    2014-01-01

    A 15-year-old boy came to the emergency department with abdominal pain in the left lower quadrant. The medical history included surgery for malrotation of bowel in two of his brothers. A CT-abdomen showed malrotation of the colon with a left-sided appendicitis and polysplenia. An emergency laparoscopic appendectomy was performed. Recovery was uneventful. PMID:24618236

  17. Idiopathic Bilateral Bloody Tearing

    PubMed Central

    Beyazy?ld?z, Emrullah; Özdamar, Yasemin; Beyazy?ld?z, Özlem; Yerli, Hasan

    2015-01-01

    Bloody tear is a rare and distinct clinic phenomenon. We report a case presenting with the complaint of recurrent episodes of bilateral bloody tearing. A 16-year-old girl presented to our clinic with complaint of bloody tearing in both eyes for 3 months. Bloody tearing was not associated with her menses. A blood-stained discharge from the punctum was not observed during the compression of both nasolacrimal ducts. Nasolacrimal passage was not obstructed. Imaging studies such as dacryocystography and gradient-echo magnetic resonance imaging (MRI) of nasolacrimal canal were normal. Intranasal endoscopic evaluation was normal. We collected samples from bloody tears two times and pathological examination was performed. Pathological analysis showed lots of squamous cells and no endometrial cells; dysplastic cells were found. Further evaluations for underlying causes were unremarkable. No abnormalities were found in ophthalmologic, radiologic, and pathologic investigations. This condition is likely a rare abnormality and the least recognized aetiology for the idiopathic phenomenon. PMID:25685572

  18. Reliability and validity of a visual analog scale for acute abdominal pain in the ED

    Microsoft Academic Search

    E. John Gallagher; Polly E. Bijur; Clarke Latimer; Wendy Silver

    2002-01-01

    The objective of the study was to assess the validity and reliability of the visual analog scale (VAS) in the measurement of acute abdominal pain, and to identify the minimum clinically significant difference in VAS scores among patients with acute abdominal pain. The study was undertaken in preparation for a randomized clinical trial of opioid use in acute abdominal pain.

  19. Characteristics of pain and stooling in children with recurrent abdominal pain

    Technology Transfer Automated Retrieval System (TEKTRAN)

    OBJECTIVE: To collect symptom data longitudinally from children with recurrent abdominal pain (RAP) and control (asymptomatic) children. PATIENTS AND METHODS: Children with RAP (n = 77) and controls (n = 33) 7 to 10 years of age completed daily diaries for 2 weeks tracking pain frequency and severi...

  20. Perioperative intravenous flurbiprofen reduces postoperative pain after abdominal hysterectomy

    Microsoft Academic Search

    Masayasu Nakayama; Hiromichi Ichinose; Shuji Yamamoto; Ken-ichi Nakabayashi; Osamu Satoh; Akiyoshi Namiki

    2001-01-01

    Purpose: To assess whether perioperative intravenous administration of flurbiprofen, a non-steroidal anti-inflammatory drug, reduced\\u000a postoperative pain after abdominal hysterectomy.\\u000a \\u000a \\u000a Methods: Forty-five patients undergoing abdominal hysterectomy were randomly assigned to one of three groups of equal size. A control\\u000a group (CONT) received a placebo 30 min before and at the end of surgery. The other two groups, PRE and POST, received

  1. Pathology Case Study: Severe Abdominal Pain

    NSDL National Science Digital Library

    Davie, James

    This is a case study presented by the University of Pittsburgh Department of Pathology in which a 16 year old boy returns after a diagnosis of presumptive gastroenteritis. During his return visit he complained of unremitting severe sharp, crampy pain in the lower abdomen, with occasional radiation in the back. Visitors are given admission data, surgical notes, gross and microscopic descriptions, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in gastrointestinal pathology.

  2. Misdiagnosis of Abdominal Pain in Pregnancy: Acute Pancreatitis

    PubMed Central

    Samal, Sunita; Gupta, Shweta; Begum, Jasmina; Ghose, Seetesh

    2015-01-01

    We report a case of acute pancreatitis in a pregnant woman who presented to our emergency department with complaints of severe abdominal pain, was misdiagnosed as scar dehiscence and underwent emergency repeat caesarean section at 33 wks for fetal distress. The preterm baby developed severe respiratory distress and succumbed on the second postnatal day. Persistent severe pain in the postoperative period in the mother prompted further evaluation which led to a diagnosis of acute pancreatitis. Conservative and supportive management was instituted leading to an eventual favourable maternal outcome. PMID:25738042

  3. Misdiagnosis of abdominal pain in pregnancy: acute pancreatitis.

    PubMed

    Pallavee, P; Samal, Sunita; Gupta, Shweta; Begum, Jasmina; Ghose, Seetesh

    2015-01-01

    We report a case of acute pancreatitis in a pregnant woman who presented to our emergency department with complaints of severe abdominal pain, was misdiagnosed as scar dehiscence and underwent emergency repeat caesarean section at 33 wks for fetal distress. The preterm baby developed severe respiratory distress and succumbed on the second postnatal day. Persistent severe pain in the postoperative period in the mother prompted further evaluation which led to a diagnosis of acute pancreatitis. Conservative and supportive management was instituted leading to an eventual favourable maternal outcome. PMID:25738042

  4. Chronic abdominal pain in a patient with escobar syndrome.

    PubMed

    Ural, Ülkü Mete; Tek?n, Ye?im Bayo?lu; Kir ?ah?n, Figen; Erd?vanli, Ba?ar; Kazdal, H?z?r

    2015-01-01

    Escobar syndrome is characterized with multiple pterygia or webs of the skin and multiple congenital anomalies. We present a 15-year-old patient with Escobar syndrome who complained of persistent blunt abdominal pain for 1 year. Preoperative evaluation confirmed the diagnosis of imperforate hymen, and the patient underwent hymenectomy under intravenous sedation. The patient's postoperative course was uneventful and her complaints resolved completely. After a 3-month follow-up, she reported having normal menstrual bleeding intervals each month without any complications. Patients with Escobar syndrome may suffer from abdominal pain due to imperforate hymen. Careful evaluation of these patients must include a complete gynaecological assessment and, if indicated, surgical treatment must be performed without delay. PMID:25196531

  5. Treatment of acute abdominal pain in the emergency room: a systematic review of the literature.

    PubMed

    Falch, C; Vicente, D; Häberle, H; Kirschniak, A; Müller, S; Nissan, A; Brücher, B L D M

    2014-08-01

    Appropriate pain therapy prior to diagnosis in patients with acute abdominal pain remains controversial. Several recent studies have demonstrated that pain therapy does not negatively influence either the diagnosis or subsequent treatment of these patients; however, current practice patterns continue to favour withholding pain medication prior to diagnosis and surgical treatment decision. A systematic review of PubMed, Web-of-Science and The-Cochrane-Library from 1929 to 2011 was carried out using the key words of 'acute', 'abdomen', 'pain', 'emergency' as well as different pain drugs in use, revealed 84 papers. The results of the literature review were incorporated into six sections to describe management of acute abdominal pain: (1) Physiology of Pain; (2) Common Aetiologies of Abdominal Pain; (3) Pre-diagnostic Analgesia; (4) Pain Therapy for Acute Abdominal Pain; (5) Analgesia for Acute Abdominal Pain in Special Patient Populations; and (6) Ethical and Medico-legal Considerations in Current Analgesia Practices. A comprehensive algorithm for analgesia for acute abdominal pain in the general adult population was developed. A review of the literature of common aetiologies and management of acute abdominal pain in the general adult population and special patient populations seen in the emergency room revealed that intravenous administration of paracetamol, dipyrone or piritramide are currently the analgesics of choice in this clinical setting. Combinations of non-opioids and opioids should be administered in patients with moderate, severe or extreme pain, adjusting the treatment on the basis of repeated pain assessment, which improves overall pain management. PMID:24449533

  6. An unusual cause of acute abdominal pain in dengue fever.

    PubMed

    Waseem, Tariq; Latif, Hina; Shabbir, Bilquis

    2014-07-01

    Dengue fever is an acute febrile viral disease caused by the bite of Aedes aegypti mosquito. It is a major health problem especially in tropical and subtropical areas including South East Asia and Pakistan. In the past few years, dengue fever has been endemic in Northern Punjab. Physicians managing dengue fever come across varied and uncommon complications of dengue fever. We report a case of dengue fever that developed severe right upper quadrant abdominal pain and induration after extreme retching and vomiting for 2 days. A rectus sheath hematoma was confirmed on noncontrast computed tomography (CT). Rectus sheath hematoma as a complication of dengue fever has rarely been reported before and never from this part of the world. Rectus sheath hematoma is an uncommon and often clinically misdiagnosed cause of abdominal pain. It is the result of bleeding into the rectus sheath from damage to the superior or inferior epigastric artery or their branches or from a direct tear of the rectus muscle. It can mimic almost any abdominal condition (See Fig.) (See Table). PMID:24560393

  7. Efficacy of hepatobiliary imaging in acute abdominal pain: concise communication

    SciTech Connect

    Freitas, J.E.; Fink-Bennett, D.M.; Thrall, J.H.; Resinger, W.W.; Calderon, H.C.; Mirkes, S.H.; Shah, P.K.

    1980-10-01

    To assess prospectively the usefulness of hepatobiliary imaging in acute abdominal pain (72 hr or less), 36 patients were scintigraphed. Before the procedure, the referring physician completed Part I of a questionnaire indicating his differential diagnosis, diagnostic confidence (expressed as a percentage), and therapeutic plan. Immediately after the test, the same physician with knowledge of the results, completed Part II of the questionnaire indicating again his differential diagnosis, diagnostic confidence, and therapeutic plan. The impact of the imaging on the physician's diagnostic confidence was expressed as a log-likelihood-ratio (LLR).

  8. Abdominal Pain: A Comparison between Neurogenic Bowel Dysfunction and Chronic Idiopathic Constipation.

    PubMed

    Faaborg, Pia Møller; Finnerup, Nanna Brix; Christensen, Peter; Krogh, Klaus

    2013-01-01

    Introduction. Most spinal-cord-injured patients have constipation. One-third develop chronic abdominal pain 10 years or more after injury. Nevertheless, very little is known about the nature of abdominal pain after spinal cord injury (SCI). It may be neuropathic or caused by constipation. Aim. To compare characteristics of abdominal pain in SCI with able-bodied with chronic idiopathic constipation (CIC). Subjects and Methods. 21 SCI and 15 CIC patients were referred for treatment of bowel symptoms. Constipation-related symptoms were assessed with the Cleveland Constipation Scoring System and the International Spinal Cord Injury Basic Bowel Function Data Set. Characteristics of abdominal pain were described using the Brief Danish Pain Questionnaire. Total gastrointestinal transit times (GITT) were measured by radiopaque markers. Results. Seventeen (81%) SCI and 14 (93%) CIC patients reported abdominal pain or discomfort within the last month (P = 0.38). Pain was considered more intense by CIC than by SCI patients (P < 0.05). Only minor differences were found in patient's qualitative description of abdominal pain or in the location of pain. In neither SCI nor CIC was pain associated with GITT. Conclusion. Most characteristics of abdominal pain among SCI patients resemble those of CIC. This indicates that constipation is a major cause of pain after SCI. PMID:24159329

  9. Non-specific abdominal pain: the resource implications.

    PubMed

    Sheridan, W G; White, A T; Havard, T; Crosby, D L

    1992-05-01

    Non-specific abdominal pain (NSAP) is responsible for a significant proportion of emergency surgical admissions with resultant resource implications. The extent of the problem was assessed in a consecutive group of 100 patients, aged between 15 and 35 years, admitted with lower abdominal pain to one general surgical firm. No less than 67 of these patients (67%) were diagnosed as having NSAP (13.29% of all general surgical admissions), most (75%) being female and having a mean hospital stay of 4.1 days. Only 11 patients (11%) had appendicitis and the remaining 22 had miscellaneous gynaecological, urological or gastrointestinal problems. Detailed analysis of the resources used revealed that the mean cost to the NHS of each case of NSAP was 807 pounds, the bulk of which was attributable to the hospital stay. Wider assessment of the problem (by means of postal questionnaire) suggests that the cost to the NHS in Wales is in the region of 6 million pounds per year and may be over 100 million pounds per year in the UK as a whole. PMID:1616261

  10. Hereditary angioedema-presenting as recurrent abdominal pain.

    PubMed

    Killedar, Madhura Milind; Malani, Anand S

    2011-12-01

    We report a very rare case of HEREDITARY ANGIOEDEMA, presenting as recurrent acute abdomen. A 22 yr old Maharastrian male, law college student, got admitted for about fifteen times in previous three years for severe, acute onset, upper abdominal pain, vomiting, distention and acute exudative inflammatory ascites .The whole episode used to subside spontaneously within 2-3 days with or without conservative general management .He underwent various investigations from far basic type, to advanced and invasive type with each recurrence but without definitive diagnosis. He also underwent unnecessary appendectomy. The authors did a review of his previous records, but didn't find any definite surgical or medical cause for his acute abdomen. Obviously it was something rare. Authors did search for it in various surgical and medical literature and searched extensively on internet for rare causes of abdominal pain which guided them for further appropriate investigations and diagnose him as a case of HEREDITARY ANGIOEDEMA ,as his clinical features and C1-INH,C3-C4 levels were strongly in favour of it . It goes without saying that the internet has become a standard accessory to conventional literature for cases with diagnostic dilemmas and for treatment options as well. PMID:23204705

  11. Experiences of Indonesian Mother Managing Preschool Children's Acute Abdominal Pain in Taiwan.

    PubMed

    Tseng, Chiu-Lien; Huang, Chu-Yu; Park, Jeong-Hwan; Lin, Hung-Ru; Liang, Shu-Yuan; Cheng, Su-Fen

    2015-01-01

    The aim of this study was to understand the Indonesian mothers' experiences of managing preschool children's acute abdominal pain. The descriptive qualitative research design comprises semi-structured interviews with 11 Indonesian mothers. The qualitative content analysis revealed three themes, including (1) insight of abdominal pain, (2) "inheritance of the strategies for assessment of management for abdominal pain from the family of origin", (3) "obstacles and insights related to cultural differences". The results presented that pain management was affected by family, environment, cultural background and religious beliefs. Healthcare providers should provide culturally competent pain management care for the patients of difference nationalities. PMID:25173181

  12. Contribution of Pain to Inspiratory Muscle Dysfunction after Upper Abdominal Surgery A Randomized Controlled Trial

    Microsoft Academic Search

    THEODOROS VASSILAKOPOULOS; ZAFIRIA MASTORA; PARASKEVI KATSAOUNOU; GEORGE DOUKAS; SERAFIM KLIMOPOULOS; CHARIS ROUSSOS; SPYROS ZAKYNTHINOS

    Upper abdominal surgery causes respiratory muscle dysfunction. Multiple factors have been implicated in the occurrence of such dysfunction; however, the role of pain remains unclear. To eluci- date the role of pain, we studied 50 patients undergoing elective upper abdominal surgery in a randomized, controlled investiga- tion. Inspiratory and expiratory muscle function were assessed through sniff mouth pressure (Psniff) and

  13. Recollection of childhood abdominal pain in adults with functional gastrointestinal disorders

    PubMed Central

    CHITKARA, DENESH K.; TALLEY, NICHOLAS J.; SCHLECK, CATHY; ZINSMEISTER, ALAN R.; SHAH, NILAY D.; LOCKE, G. RICHARD

    2009-01-01

    Objective It is hypothesized that adults who can recall abdominal pain as children are at risk of experiencing a functional gastrointestinal disorder (FGID), but this is not specific to any particular FGID. The aim of this study was to evaluate the association between recollecting abdominal pain as a child and experiencing a FGID. Material and methods A valid self-reported questionnaire of GI symptoms was mailed to a random population-based sample in Olmsted County, Minnesota. Logistic regression models adjusting for age, gender, body mass index (BMI), somatization, and other factors were used to estimate the odds ratios (ORs) for having a FGID in individuals recalling bouts of stomach or abdominal pain in childhood (before age 15). Results Overall, 2298 (55%) of a total of 4194 eligible adult subjects returned a completed questionnaire. Of the respondents, 213 (9%) recalled experiencing abdominal pain as children. Adults who recalled experiencing abdominal pain in childhood had greater odds for reporting symptoms of a FGID (OR 1.9; 95% CI 1.4–2.7). Recalling abdominal pain in childhood was significantly associated with irritable bowel syndrome (IBS) (OR 2.5; 95% CI 1.7–3.6) but not gastroesophageal reflux, dyspepsia, constipation, or diarrhea, adjusting for age, gender, BMI, somatic symptoms, marital status, and education. Conclusions Recollection of childhood abdominal pain is specifically associated with IBS in adults. This suggests that a proportion of adults with IBS may have onset of symptoms of abdominal pain during childhood. PMID:19016078

  14. Incidence of familial Mediterranean fever (FMF) mutations among children of Mediterranean extraction with functional abdominal pain

    Microsoft Academic Search

    Riva Brik; Dianna Litmanovitz; Drora Berkowitz; Raanan Shamir; Eldad Rosenthal; Marwan Shinawi; Ruth Gershoni-Baruch

    2001-01-01

    Of 59 Sephardic Jewish and Arab children in whom functional abdominal pain was diagnosed, we found that 20% were homozygote for the familial Mediterranean fever gene. Inclusion of genetic screening for familial Mediterranean fever may be advisable in the investigation of recurrent abdominal pain among children of Mediterranean extraction. (J Pediatr 2001;138:759-62)

  15. New Bloody Sunday Inquiry

    NSDL National Science Digital Library

    de Nie, Michael Willem.

    1998-01-01

    This week's In the News discusses the recent decision to reopen the investigation into Bloody Sunday. The nine resources discussed provide background information, analysis, and commentary. On January 30, 1972 British paratroopers shot dead thirteen people taking part in a protest march in the Northern Ireland city of Derry. The soldiers insisted that they had come under attack by members of the Irish Republican Army (IRA) and only fired at those possessing weapons. This claim was and continues to be strongly denied by march participants and eyewitnesses. Bloody Sunday has remained an emotive issue in Ireland, partially because of intense dissatisfaction with the official investigation conducted at the time. In a hastily researched report, Lord Widgery granted that none of the victims could be proved to have had weapons when they were shot, but there was "a strong suspicion that some others had been firing weapons or handling bombs in the course of the afternoon." After years of prodding by Catholic nationalists in the North and the government of the Irish Republic, the British government, led by Prime Minister Tony Blair, has announced that they will reopen the investigation into Bloody Sunday as part of their larger efforts to secure a lasting peace in Northern Ireland.

  16. Partially hydrolyzed guar gum in pediatric functional abdominal pain

    PubMed Central

    Romano, Claudio; Comito, Donatella; Famiani, Annalisa; Calamarà, Sabrina; Loddo, Italia

    2013-01-01

    AIM: To assess the effects of partially hydrolyzed guar gum (PHGG) diet supplement in pediatric chronic abdominal pain (CAP) and irritable bowel syndrome (IBS). METHODS: A randomized, double-blind pilot study was performed in sixty children (8-16 years) with functional bowel disorders, such as CAP or IBS, diagnosed according to Rome III criteria. All patients underwent ultrasound, blood and stool examinations to rule out any organic disease. Patients were allocated to receive PHGG at dosage of 5 g/d (n = 30) or placebo (fruit-juice n = 30) for 4 wk. The evaluation of the efficacy of fiber supplement included IBS symptom severity score (Birmingham IBS Questionnaire), severity of abdominal pain (Wong-Baker Face Pain Rating Score) and bowel habit (Bristol Stool Scale). Symptom scores were completed at 2, 4, and 8 wk. The change from baseline in the symptom severity scale at the end of treatment and at 4 wk follow-up after treatment was the primary endpoint. The secondary endpoint was to evaluate compliance to supplementation with the PHGG in the pediatric population. Differences within groups during the treatment period and follow-up were evaluated by the Wilcoxon signed-rank test. RESULTS: The results of the study were assessed considering some variables, such as frequency and intensity of symptoms with modifications of the bowel habit. Both groups were balanced for baseline characteristics and all patients completed the study. Group A (PHGG group) presented a higher level of efficacy compared to group B (control group), (43% vs 5%, P = 0.025) in reducing clinical symptoms with modification of Birmingham IBS score (median 0 ± 1 vs 4 ± 1, P = 0.025), in intensity of CAP assessed with the Wong-Baker Face Pain Rating Score and in normalization of bowel habit evaluated with the Bristol Stool Scale (40% vs 13.3%, P = 0.025). In IBS subgroups, statistical analysis shown a tendency toward normalization of bowel movements, but there was no difference in the prevalence of improvement in two bowel habit subsets. PHGG was therefore better tolerated without any adverse effects. CONCLUSION: Although the cause of pediatric functional gastrointestinal disorders is not known, the results show that complementary therapy with PHGG may have beneficial effects on symptom control. PMID:23345946

  17. Recurrent abdominal pain in a woman with a wandering spleen.

    PubMed

    Tan, H H; Ooi, L L P L; Tan, D; Tan, C K

    2007-04-01

    A 28-year-old Malay woman presented with recurrent abdominal pain for five years. She had delivered her child seven months earlier. She was found to have bicytopenia, with a haemoglobin level of 7.9 g/dL and a platelet count of 85 x 10(9)/L. Computed tomography revealed a wandering spleen. Complications of a wandering spleen, for which splenectomy is advocated, include functional asplenia (due to torsion of the splenic pedicle), splenic infarction or splenic vessel thrombosis. A splenectomy was performed and at operation, splenomegaly with a long mesentery was found. Splenic histology was negative for malignancy. The bicytopenia resolved postoperatively, and she remains well. PMID:17384868

  18. Acute abdominal pain in systemic lupus erythematosus: focus on lupus enteritis (gastrointestinal vasculitis)

    PubMed Central

    Lee, C; Ahn, M; Lee, E; Shin, J; Cho, Y; Ha, H; Yoo, B; Moon, H

    2002-01-01

    Methods: A retrospective study was carried out for all patients admitted with SLE from 1993 to March 2001. The SLEDAI and laboratory data were collected at the time of diagnosis of SLE and at the time of acute abdominal pain. Lupus enteritis (gastrointestinal vasculitis) was diagnosed by clinical investigation and abdominal computed tomographic findings. Results: Chart review identified 175 patients (20 male, 155 female) who had been admitted with SLE. Of these patients, 38 (22%) presented with acute abdominal pain. Lupus enteritis was the most common cause of acute abdominal pain. Patients were divided into three groups: group 1: lupus enteritis (n=17), group 2: acute abdominal pain without lupus enteritis (n=21), and group 3: SLE without acute abdominal pain (n=137). There was no difference in age and sex among the three groups. Antiphospholipid, anti-RNP, anti-Sm, anti-Ro, and anti-La antibodies did not differ among the three groups. There was no difference in the SLEDAI at the time of diagnosis and at the time of acute abdominal pain between groups 1 and 2. Complement, erythrocyte sedimentation rate, C reactive protein, and anti-dsDNA measured at the time of acute abdominal pain did not differ between groups 1 and 2. A drop in the white blood cell count at the time of abdominal pain was more prominent in group 1 than group 2. In lupus enteritis, the jejunum and ileum were the sites most commonly affected. Rectal involvement was rare. Even though four patients relapsed, all the patients with lupus enteritis, including those who relapsed, responded well to corticosteroid. Conclusion: Lupus enteritis is the most common cause of acute abdominal pain in SLE. All patients with lupus enteritis responded well to a high dose of a corticosteroid without surgical intervention. The SLEDAI and laboratory data, except leucopenia, do not correlate with the occurrence of lupus enteritis. PMID:12006332

  19. Factors contributing to poor post-operative abdominal pain management in adult patients: a review

    Microsoft Academic Search

    Ahmad Al Samaraee; Gill Rhind; Usama Saleh; Vish Bhattacharya

    2010-01-01

    Post-operative abdominal pain management can be a major issue facing medical and nursing staff in daily clinical practice. Effective pain control reduces post-operative morbidity as well as facilitates rehabilitation and accelerates recovery from surgery. In turn, poor pain control has been shown to alter body metabolic response that can lead to delayed recovery, with subsequent prolonged hospital stay and increased

  20. Intractable Abdominal Pain in a Patient With Spinal Cord Injury: A Case Report

    PubMed Central

    Park, Hye Kyung; Song, Dae Heon; Kim, Young Moon; Kim, Hong Geum; Kim, Soo Yeon

    2013-01-01

    Patients with spinal cord injury (SCI) may experience several types of chronic pains. Abdominal pain in patients with SCI has gained limited attention and little is yet known about its characteristics and mechanisms. It often has been regarded as visceral pain associated with constipation and distention. Neuropathic pains localized in the abdomen have rarely been reported. We experience a case of intractable abdominal pain in a patient with SCI, neither of visceral pathology nor of musculoskeletal origin. The nature of pain fulfilled the diagnostic criteria for neuropathic pains. The pain was therefore regarded as neuropathic and managed accordingly. The first- and second-line oral drugs available were being performed, unfortunately, adequate pain control was not achieved. We tried an intrathecal lidocaine injection as another treatment option, and the injection had considerable effects. PMID:24236262

  1. FACTORS RELATED TO ABDOMINAL PAIN IN GASTROPARESIS: CONTRAST TO PATIENTS WITH PREDOMINANT NAUSEA AND VOMITING

    PubMed Central

    2013-01-01

    Background Factors associated with abdominal pain in gastroparesis are incompletely evaluated and comparisons of pain versus other symptoms are limited. This study related pain to clinical factors in gastroparesis and contrasted pain/discomfort- with nausea/vomiting-predominant disease. Methods Clinical and scintigraphy data were compared in 393 patients from 7 centers of the NIDDK Gastroparesis Clinical Research Consortium with moderate-severe (Patient Assessment of Upper Gastrointestinal Disorders Symptoms [PAGI-SYM] score ?3) vs. none-mild (PAGI-SYM <3) upper abdominal pain and predominant pain/discomfort vs. nausea/vomiting. Key Results Upper abdominal pain was moderate-severe in 261 (66%). Pain/discomfort was predominant in 81 (21%); nausea/vomiting was predominant in 172 (44%). Moderate-severe pain was more prevalent with idiopathic gastroparesis and with lack of infectious prodrome (P?0.05) and correlated with scores for nausea/vomiting, bloating, lower abdominal pain/discomfort, bowel disturbances, and opiate and antiemetic use (P<0.05) but not gastric emptying or diabetic neuropathy or control. Gastroparesis severity, quality of life, and depression and anxiety were worse with moderate-severe pain (P?0.008). Factors associated with moderate-severe pain were similar in diabetic and idiopathic gastroparesis. Compared to predominant nausea/vomiting, predominant pain/discomfort was associated with impaired quality of life, greater opiate, and less antiemetic use (P<0.01), but similar severity and gastric retention. Conclusions & Inferences Moderate-severe abdominal pain is prevalent in gastroparesis, impairs quality of life, and is associated with idiopathic etiology, lack of infectious prodrome, and opiate use. Pain is predominant in one fifth of gastroparetics. Predominant pain has at least as great an impact on disease severity and quality of life as predominant nausea/vomiting. PMID:23414452

  2. Predictors of Abdominal Pain in Depressed Pediatric Inflammatory Bowel Disease Patients

    PubMed Central

    Srinath, Arvind I.; Goyal, Alka; Zimmerman, Lori A.; Newara, Melissa C.; Kirshner, Margaret A.; McCarthy, F. Nicole; Keljo, David; Binion, David; Bousvaros, Athos; DeMaso, David R.; Youk, Ada; Szigethy, Eva M.

    2015-01-01

    Background Pediatric patients with inflammatory bowel disease (IBD) have high rates of abdominal pain. The study aims were to (1) Evaluate biological and psychological correlates of abdominal pain in depressed youth with IBD, (2) Determine predictors of abdominal pain in Crohn’s disease (CD) and ulcerative colitis (UC). Methods 765 patients ages 9–17 with IBD seen over 3 years at two sites were screened for depression. Depressed youth completed comprehensive assessments for abdominal pain, psychological (depression and anxiety), and biological (IBD-related, through disease activity indices and laboratory values) realms. Results 217 patients with IBD (161 CD, 56 UC) were depressed. 163 (120 CD, 43 UC) patients had complete API scores. In CD, abdominal pain was associated with depression (r=0.33; p<0.001), diarrhea (r=0.34; p=0.001), ESR (r=0.22; p=0.02), low albumin (r=0.24; p=.01), weight loss (r=0.33; p=0.001), and abdominal tenderness (r=0.38, p=0.002). A multivariate model with these significant correlates represented 32% of the variance in pain. Only depression (p=0.03), weight loss (p=0.04), and abdominal tenderness (p=0.01) predicted pain for CD patients. In UC, pain was associated with depression (r=0.46; p=0.002) and nocturnal stools (r=.32; p=.046). In the multivariate model with these significant correlates 23% of the variance was explained, and only depression (p=0.02) predicted pain. Conclusions The psychological state of pediatric patients with IBD may increase the sensitivity to abdominal pain. Thus, screening for and treating comorbid depression may prevent excessive medical testing and unnecessary escalation of IBD medications. PMID:24983975

  3. Severe Abdominal Pain as the First Manifestation of Rabies

    PubMed Central

    Ayatollahi, Jamshid; Sharifi, Mohammad Reza; Shahcheraghi, Seyed Hossein

    2014-01-01

    Introduction: Rabies is an acute fatal viral disease that is generally transmitted from animals to humans following wild and domestic animal bites. The rabies virus enters the body from the area where the individual is bitten, and then the virus moves towards the brain and involves the nerves. Case Presentation: During the years 2001-2011, there have been 73 reported rabies cases. About 50,000 reported human deaths are annually due to rabies. The actual number of human deaths due to rabies in Asia especially India, Pakistan and Bangladesh are more than these numbers, since there is no advanced surveillance system for disease control to determine the actual number of infected and fatal human cases. According to the World Health Organization (WHO) reports, more than 10 million people who are bitten by animals are annually treated by prophylactic treatment regimens for rabies, worldwide. Conclusions: This paper reports on a case of human rabies with the first disease manifestation (severe abdominal pain). The patient reported extensive biting on his left leg by a dog. He had a slight fever of 38.1°C. It has been recommended that a careful history should be taken from patients for diagnosis of rabies disease. A complete history should be taken from patients for diagnosis of disease, because rabies could be wrong with various diseases with atypical symptoms. because various diseases with atypical symptoms or long incubation periods can visit. PMID:25485053

  4. Recurrent Abdominal Pain and Irritable Bowel Syndrome in Children

    PubMed Central

    McOmber, Mark E.; Shulman, Robert J.

    2010-01-01

    Purpose of Review Recurrent abdominal pain (RAP) continues to be one of the most ubiquitous conditions faced by the healthcare team and has a significant emotional and economic impact. We have moved from considering it a psychological condition to recognizing the physiological and environmental contributions and considering the condition in the framework of a biopsychosocial model where biology, psychology, and social environment interact. Here, we review current studies addressing etiologies, diagnostic techniques, and treatment options for RAP in children. Recent Findings Studies continue to highlight the role of visceral hypersensitivity in RAP. However, the psychological state of the child and the parent (most often the mother) in terms of their anxiety, somatization, and coping skills can modulate the expression of symptoms. Diagnosis still is made by history and physical examination. Newer treatment options include relaxation and distraction therapies as well as medications. The role of probiotics in children remains to be defined. Summary The approach to the child with RAP must include the recognition of the physiological contributions and this information must be relayed to the child and parents. Acknowledgement also must be paid to the role of psychological state in the parent as well as in the child in modulating the severity of symptoms. PMID:17885479

  5. Toothpick perforation of the intestines presenting as recurrent abdominal pain: possible roles of abdominal ultrasound and MRI.

    PubMed

    Sealock, Robert J; Sabounchi, Saman; Graham, David Y

    2013-01-01

    We report the case of a middle-aged man admitted for five months of unexplained left lower quadrant pain. He had been hospitalized on two prior occasions and treated with broad spectrum antibiotics. His clinical presentation was suggestive peritoneal irritation with severe, focal pain on abdominal palpation. Computed tomography scans showed non-specific inflammation in the left lower abdomen with adjacent small bowel wall thickening. Upper endoscopy and colonoscopy were unremarkable on prior admission. Given the severity and focality of the patient's recurrent abdominal pain he underwent laparoscopy and was found to have a wooden toothpick perforation of the small bowel thirty centimeters from the ileocecal valve requiring partial small bowel resection. The patient did well post-operatively. On retrospective questioning he may have eaten a cabbage roll or bacon wrapped shrimp pierced with a toothpick weeks before the onset of symptoms. Toothpick perforation should be a consideration in edentulous persons with focal, severe abdominal pain and trans-abdominal ultrasound or MRI may be a better choice for detecting wooden foreign objects. PMID:23885181

  6. Congenital left paraduodenal hernia causing chronic abdominal pain and abdominal catastrophe.

    PubMed

    Shi, Yan; Felsted, Amy E; Masand, Prakash M; Mothner, Brent A; Nuchtern, Jed G; Rodriguez, J Ruben; Vasudevan, Sanjeev A

    2015-04-01

    Paraduodenal hernias are the most common type of congenital internal hernia. Because of its overall rare incidence, this entity is often overlooked during initial assessment of the patient. Lack of specific diagnostic criteria also makes diagnosis exceedingly difficult, and the resulting diagnostic delays can lead to tragic outcomes for patients. Despite these perceived barriers to timely diagnosis, there may be specific radiographic findings that, when combined with the appropriate constellation of clinical symptoms, would aid in diagnosis. This patient first presented at 8 years of age with vague symptoms of postprandial emesis, chronic abdominal pain, nausea, and syncope. Over the span of 6 years he was evaluated 2 to 3 times a year with similar complaints, all of which quickly resolved spontaneously. He underwent multiple laboratory, imaging, and endoscopic studies, which were nondiagnostic. It was not until he developed signs of a high-grade obstruction and extremis that he was found to have a large left paraduodenal hernia that had volvulized around the superior mesenteric axis. This resulted in the loss of the entire superior mesenteric axis distribution of the small and large intestine and necrosis of the duodenum. In cases of chronic intermittent obstruction without clear etiology, careful attention and consideration should be given to the constellation of symptoms, imaging studies, and potential use of diagnostic laparoscopy. Increased vigilance by primary care and consulting physicians is necessary to detect this rare but readily correctable condition. PMID:25802350

  7. Eighty-two year old female with long term abdominal pain, fever and skin lesions.

    PubMed

    Muñiz Nicolás, G; Zafar Iqbal-Mirza, S; Gonzáles Carhuancho, J A; Mollejo Villanueva, M

    2014-09-01

    We report the case of an old woman, consulting for fever, abdominal pain and constitutional symptoms one year of evolution. The differential diagnosis is between infectious, tumoral, or inflammatory disease, which may be located at the abdominal level, performing additional tests to rule out abdominal process. The existence of pain in the legs and level scan left thigh of a mass of hard consistency, makes us raise another diagnosis. Finally show on ultrasound soft tissue inflammatory changes regarding panniculitis. From this finding aetiologies of panniculitis are reviewed. Skin biopsy that shows the final diagnosis is made. PMID:25205432

  8. Cognitive-Behavioral Therapy for Children With Functional Abdominal Pain and Their Parents Decreases Pain and Other Symptoms

    PubMed Central

    Levy, Rona L.; Langer, Shelby L.; Walker, Lynn S.; Romano, Joan M.; Christie, Dennis L.; Youssef, Nader; DuPen, Melissa M.; Feld, Andrew D.; Ballard, Sheri A.; Welsh, Ericka M.; Jeffery, Robert W.; Young, Melissa; Coffey, Melissa J.; Whitehead, William E.

    2011-01-01

    OBJECTIVES Unexplained abdominal pain in children has been shown to be related to parental responses to symptoms. This randomized controlled trial tested the efficacy of an intervention designed to improve outcomes in idiopathic childhood abdominal pain by altering parental responses to pain and children's ways of coping and thinking about their symptoms. METHODS Two hundred children with persistent functional abdominal pain and their parents were randomly assigned to one of two conditions—a three-session intervention of cognitive-behavioral treatment targeting parents' responses to their children's pain complaints and children's coping responses, or a three-session educational intervention that controlled for time and attention. Parents and children were assessed at pretreatment, and 1 week, 3 months, and 6 months post-treatment. Outcome measures were child and parent reports of child pain levels, function, and adjustment. Process measures included parental protective responses to children's symptom reports and child coping methods. RESULTS Children in the cognitive-behavioral condition showed greater baseline to follow-up decreases in pain and gastrointestinal symptom severity (as reported by parents) than children in the comparison condition (time × treatment interaction, P < 0.01). Also, parents in the cognitive-behavioral condition reported greater decreases in solicitous responses to their child's symptoms compared with parents in the comparison condition (time × treatment interaction, P < 0.0001). CONCLUSIONS An intervention aimed at reducing protective parental responses and increasing child coping skills is effective in reducing children's pain and symptom levels compared with an educational control condition. PMID:20216531

  9. Unusual case of abdominal pain following liver transplant: causality or casualty?

    PubMed

    Ausania, F; Sen, S; Davies, S E; Gimson, A E; Gibbs, P

    2011-01-01

    This is an unusual case of chronic abdominal pain following two liver transplants with at least three potential causes: traumatic neuroma, intussusception of the small bowel of the Roux loop and biliary cast. Surgical removal of the latter two factors led to resolution of the pain. The management of the clinical case is discussed. PMID:22217373

  10. Increased gastrointestinal permeability and gut inflammation in children with functional abdominal pain and Irritable Bowel Syndrome

    Technology Transfer Automated Retrieval System (TEKTRAN)

    To determine gastrointestinal (GI) permeability and fecal calprotectin concentration in children 7 to 10 years of age with functional abdominal pain and irritable bowel syndrome (FAP/IBS) versus control subjects and ascertain potential relationships with pain symptoms and stooling, GI permeability a...

  11. Abdominal musculature abnormalities as a cause of groin pain in athletesInguinal hernias and pubalgia

    Microsoft Academic Search

    Dean C. Taylor; William C. Meyers; Joseph A. Moylan; John Lohnes; Frank H. Bassett; William E. Garrett

    1991-01-01

    There has been increasing interest within the European sports medicine community regarding the etiology and treatment of groin pain in the athlete. Groin pain is most commonly caused by musculotendinous strains of the adductors and other muscles crossing the hip joint, but may also be related to abdominal wall abnormalities. Cases may be termed \\

  12. Does laparoscopy used in open exploration alleviate pain associated with chronic intractable abdominal wall neuralgia?

    Microsoft Academic Search

    H. Paajanen

    2006-01-01

    Background  This study aimed to assess the efficacy of diagnostic laparoscopy and open exploration of trigger points (scar revision and\\u000a neurectomy) in the treatment of intractable chronic abdominal wall pain.\\u000a \\u000a \\u000a \\u000a Methods  This prospective nonrandomized study enrolled 24 patients (21 women) with an average age of 59 ± 11 years. Abdominal wall\\u000a pain was diagnosed by excluding other causes of pain and using

  13. Antinociceptive effect of botulinum toxin type A on experimental abdominal pain.

    PubMed

    Drinovac, Višnja; Bach-Rojecky, Lidija; Babi?, Ana; Lackovi?, Zdravko

    2014-12-15

    Visceral pain, especially in the abdominal region, represents one of the most common types of pain. Its chronic form is usually very hard to treat by conventional analgesic agents and adjuvants. We investigated the antinociceptive effect of botulinum toxin type A (BTX-A) in male Wistar rats in two models of visceral pain: peritonitis induced by intraperitoneal injection of 1% acetic acid and colitis induced by intracolonic instillation of 0.1% capsaicin. Pain was measured as the number of abdominal writhes. Additionally, referred mechanical sensitivity in the ventral abdominal area was evaluated by von Frey test and the extent of spinal c-Fos expression was immunohistochemically examined. BTX-A significantly reduced the number of abdominal writhes in both models of visceral pain after intrathecal application in a dose of 2 U/kg. In the experimental colitis model, BTX-A (2 U/kg) reduced both referred mechanical allodynia and c-Fos expression in the dorsal horn of the spinal cord (S2/S3 segments). In contrast to intrathecal administration, BTX-A (2 U/kg) administered into the cisterna magna had no effect on pain suggesting that the primary site of its action is a spinal cord. PMID:25446429

  14. Untreatable Pain Resulting from Abdominal Cancer: New Hope from Biophysics?

    Microsoft Academic Search

    Giuseppe Marineo

    2003-01-01

    Context Visceral pain characterizing pancreatic cancer is the most difficult symptom of the disease to control and can significantly impair the quality of life which remains and increase the demand for euthanasia. Aim To investigate a possible new method based on biophysical principles (scrambler therapy) to be used in the effective treatment of drug-resistant oncological pain of the visceral\\/neuropathic type.

  15. Abdominal pain related to mitochondrial neurogastrointestinal encephalomyopathy syndrome may benefit from splanchnic nerve blockade.

    PubMed

    Celebi, Nalan; Sahin, Altan; Canbay, Ozgür; Uzümcügil, Filiz; Aypar, Ulkü

    2006-10-01

    Patients diagnosed with abdominal pain related to mitochondrial neurogastrointestinal encephalopathy (MNGIE) may benefit from splanchnic nerve blockade. MNGIE, varying in age of onset and rate of progression, is caused by loss of function mutation in thymidine phosphorylase gene. Gastrointestinal dysmotility, pseudo-obstruction and demyelinating sensorimotor peripheral neuropathy (stocking-glove sensory loss, absent tendon reflexes, distal limb weakness, and wasting) are the most prominent manifestations. Patients usually die in early adulthood (mean 37.6 years; range 26-58 years). We report a case of an 18-year-old patient with MNGIE. Our patient's abdominal pain was relieved after splanchnic nerve blockade. PMID:16972839

  16. A case of urachal remnant presenting as acute abdominal pain

    Microsoft Academic Search

    Scott Schlaishunt; Jonathan Rubin

    1999-01-01

    A 30-year-old male presented to the Emergency Department, over sequential visits, with abdominal complaints. The patient’s presenting history and physical examination were mistakenly diagnosed variously as gastroenteritis, omphalitis, and appendicitis. Ultimately, the diagnosis of urachal fistula was made at surgery. This case is discussed in light of prior published experiences with this disease entity.

  17. Efficacy of a Brief Relaxation Training Intervention for Pediatric Recurrent Abdominal Pain

    ERIC Educational Resources Information Center

    Bell, Katrina M.; Meadows, Elizabeth A.

    2013-01-01

    This study is a preliminary investigation of the efficacy of a brief intervention for recurrent abdominal pain (RAP) via a multiple baseline across subjects design. The intervention consisted of a single 1-hour session including psychoeducation and coaching of breathing retraining; the length, duration, and content of the intervention were…

  18. Improvement of Pain Treatment After Major Abdominal Surgery by Intravenous S(+)Ketamine

    Microsoft Academic Search

    Helena Argiriadou; Sabine Himmelseher; Pinelopi Papagiannopoulou; Mary Georgiou; Fotios Kanakoudis; Maria Giala; Eberhard Kochs

    2004-01-01

    The use of intraoperative racemic ketamine for pain prevention after abdominal surgery is controversial. We compared one preincisional IV injection of S()- ketamine with its preincisional and repeated intraoper- ative use in 45 patients undergoing surgery with epi- dural and general anesthesia. S()-ketamine is a new drug formulation that contains the more potent S()- stereoisomer of ketamine. Patients were randomized

  19. Sclerosing mesenteritis as a rare cause of upper abdominal pain and digestive disorders.

    PubMed

    Grieser, C; Denecke, T; Langrehr, J; Hamm, B; Hänninen, E Lopez

    2008-09-01

    Sclerosing mesenteritis is a rare inflammatory disease of the bowel mesentery of unknown etiology, which can be mistaken for malignancy. We report a case of a 60-year-old male patient with sclerosing mesenteritis as a rare cause of upper abdominal pain and digestive disorders, and present the corresponding magnetic resonance imaging (MRI) findings indicative of the underlying disease. PMID:19143059

  20. RECURRENT ABDOMINAL PAIN IN CHILDREN: FORERUNNER TO ADULT IRRITABLE BOWEL SYNDROME?

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Recurrent abdominal pain is common in children. For about one third of these children an organic cause can be identified and others resolve over time, but approximately one fourth continue to have symptoms that are typical of adult IBS. Apley (1975) initially discouraged describing the condition in ...

  1. Increased Diagnostic Yield of Capsule Endoscopy in Patients with Chronic Abdominal Pain

    PubMed Central

    Yang, Liping; Chen, Yu; Zhang, Bingling; Chen, Chunxiao; Yue, Min; Du, Juan; Yu, Chaohui; Li, Youming

    2014-01-01

    Background and Study Aims Chronic abdominal pain is one of the most common chief complaints, but the underlying pathophysiology often remains unknown after routine clinical evaluation. Capsule endoscopy (CE) is a new technique for the visualization of the entire small bowel. The aim of this study was to evaluate the diagnostic efficacy of CE in patients with chronic abdominal pain of obscure origin. Patients and Methods Two hundred forty three patients with chronic abdominal pain with no significant lesions were enrolled in this study. CE was performed in all patients. Results A diagnosis was made in 23.0% of patients screened with CE. Of the 243 patients, 19 (7.8%) were diagnosed with Crohn's disease, 15 (6.2%) with enteritis, 11 (4.5%) with idiopathic intestinal lymphangiectasia, 5 (2.1%) with uncinariasis, and a number of other diagnoses including small bowel tumor, ascariasis, and anaphylactoid purpura. Five patients had abnormal transit time, and capsule retention occurred in two patients. Conclusions In contrast to other previous studies, we found that CE is an effective diagnostic tool for patients with abdominal pain. PMID:24498097

  2. Hypnotherapy for Children With Functional Abdominal Pain or Irritable Bowel Syndrome: A Randomized Controlled Trial

    Microsoft Academic Search

    ARINE M. VLIEGER; CARLA MENKO-FRANKENHUIS; SIMONE C. S. WOLFKAMP; ELLEN TROMP; MARC A. BENNINGA

    2007-01-01

    Background & Aims: Functional abdominal pain (FAP) and irritable bowel syndrome (IBS) are highly prevalent in childhood. A substantial proportion of patients continues to experience long-lasting symptoms. Gut-directed hypnotherapy (HT) has been shown to be highly effective in the treatment of adult IBS patients. We undertook a randomized controlled trial and com- pared clinical effectiveness of HT with standard medical

  3. Imaging patterns with 99mTc-PIPIDA in evaluating abdominal pain

    SciTech Connect

    Curtis, R.F.; Gordon, L.; Selby, J.B. Sr.

    1983-11-01

    A random retrospective review of hepatobiliary scans on 86 adult patients with abdominal pain revealed four distinct imaging patterns: normal, cystic duct obstruction, obstructive, and sick liver pattern. A normal pattern was found to exclude acute cholecystitis and was the pattern most frequently observed.

  4. Giant thoracic schwannoma presenting with abrupt onset of abdominal pain: a case report

    Microsoft Academic Search

    Isaac Yang; Elena Paik; Nancy G Huh; Andrew T Parsa; Christopher P Ames

    2009-01-01

    INTRODUCTION: Giant intradural extramedullary schwannomas of the thoracic spine are not common. Schwannomas, that is, tumors derived from neoplastic Schwann cells, and neurofibromas represent the most common intradural extramedullary spinal lesions. We report the case of a patient with a giant thoracic schwannoma presenting unusually with acute abdominal pain and with delayed neurological impairment. CASE PRESENTATION: A 26-year-old Hispanic man

  5. Primary Cardiac Burkitt Lymphoma Presenting with Abdominal Pain

    PubMed Central

    Dewar, Rajan; Luptakova, Katarina; Chang, James D.; Joyce, Robin M.

    2014-01-01

    We describe the case of a 44-year-old woman with primary Burkitt lymphoma of the heart who presented with abdominal bloating and epigastric discomfort secondary to tamponade physiology caused by a large pericardial effusion. The pericardial fluid contained a large number of highly atypical lymphocytes with moderate basophilic cytoplasm, rare punched-out vacuoles, a vesicular nuclear chromatin, large nucleolus, and marginated chromatin that by FISH were positive for the 8;14 translocation. She had no other sites of disease. She was treated with four alternating cycles of modified CODOX-M and IVAC in combination with rituximab and remains in remission more than 5 years since diagnosis. PMID:25431699

  6. Pain relief after transversus abdominis plane block for abdominal surgery in children: a service evaluation

    PubMed Central

    Bergmans, Elonka; Jacobs, Alet; Desai, Rachel; Masters, Oliver W; Thies, Karl C

    2015-01-01

    We carried out a prospective service evaluation of the quality of pain control after preoperative transverse abdominis plane (TAP) block in 100 children undergoing abdominal surgery. Data were collected on type of procedure, age, weight, level of the block, local anesthetic used, additional analgesia, and hourly pain scores. Of the 100 patients, 87 were included in the evaluation, 77% of who were less than 1 year old. Adequate pain relief was achieved in 93% of all patients. Almost half (47%) of our patients did not require intravenous (IV) opioids in the postoperative period and 27% did not need any IV opioids at all. Our results confirm the good quality of perioperative analgesia achieved with a TAP block as part of a multimodal approach in children undergoing abdominal surgery. Depending on the patient’s age and the type of procedure, a TAP block may eliminate the need for IV opioids.

  7. [Professor WU Xu's clinical experiences on acupuncture for acute upper abdominal pain].

    PubMed

    Wu, Xiao-Liang; Lu, Bin; Sun, Jian-Hua; Ai, Bing-Wei; Bao, Chao; Wu, Wen-Zhong; Li, Jian-Bing; Liu, Lan-Ying; Wu, Wen-Yun; Pei, Li-Xia; Zhou, Jun-Ling; Li, Yan-Cai; Qin, Shan

    2014-03-01

    The clinical experiences and proven cases of distinguished doctor of TCM, professor WU Xu, on acupuncture for acute upper abdominal pain is introduced. Professor WU's manipulation characteristics of acupuncture for acute upper abdominal pain, including acute cholecystitis, kidney stone, acute stomach pain, are one-hand shape but both hands in nature, moving like Tai Chi, force on the tip of needle, movement of qi mainly. The main technique posture is one-hand holding needle with middle finger for pressing, the needle is hold by thumb and index finger, and is assisted by middle finger. The special acupuncture experience of emergency is treatment according to syndrome differentiation, combination of acupuncture and moxibustion, selecting acupoint based on experience, blood-letting acupuncture therapy and so on. PMID:24843977

  8. Gastric electrical stimulation for abdominal pain in patients with symptoms of gastroparesis.

    PubMed

    Lahr, Christopher J; Griffith, James; Subramony, Charu; Halley, Lindsey; Adams, Kristen; Paine, Elizabeth R; Schmieg, Robert; Islam, Saleem; Salameh, Jay; Spree, Danielle; Kothari, Truptesh; Kedar, Archana; Nikitina, Yana; Abell, Thomas

    2013-05-01

    Abdominal pain physiology may be better understood studying electrophysiology, histology, and symptom scores in patients with the symptoms of gastroparesis (Gp) treated with gastric electrical stimulation (GES). Ninety-five Gp patients' symptoms were recorded at baseline and during temporary and permanent GES. Gastric-emptying times and cutaneous, mucosal, and serosal electrogastrograms were obtained. S100-stained, full-thickness gastric biopsies were compared with autopsy controls. Sixty-eight patients reported severe pain at baseline. Severe pain patients' mean pain scores decreased with temporary GES from 3.62 to 1.29 (P < 0.001) and nonsevere pain from 1.26 to 0.67 (P = 0.01). With permanent GES, severe mean pain scores fell to 2.30 (P < 0.001); nonsevere pain changed to 1.60 (P = 0.221). Mean follow-up was 275 days. Mean cutaneous, mucosal, and serosal frequencies and frequency-to-amplitude ratios were markedly higher than literature controls. For patients with Gp overall and subdivided by etiology and severity of pain, S-100 neuronal fibers were significantly reduced in both muscularis propria layers. GES improved severe pain associated with symptoms of Gp. This severe pain is associated with abnormal electrogastrographic activity and loss of S100 neuronal fibers in the stomach's inner and outer muscularis propria and, therefore, could be the result of gastric neuropathy. PMID:23635579

  9. Twelve Month Follow-up of Cognitive Behavioral Therapy for Children with Functional Abdominal Pain

    PubMed Central

    Levy, Rona L.; Langer, Shelby L.; Walker, Lynn S.; Romano, Joan M.; Christie, Dennis L.; Youssef, Nader; DuPen, Melissa M.; Ballard, Sheri A.; Labus, Jennifer; Welsh, Ericka; Feld, Lauren D.; Whitehead, William E.

    2014-01-01

    Objective To determine whether a brief intervention for children with functional abdominal pain and their parents' responses to their child's pain resulted in improved coping 12 months later. Design Prospective, randomized, longitudinal study. Setting Families were recruited during a 4-year period in Seattle, WA and Morristown, NJ. Participants 200 children with persistent functional abdominal pain and their parents. Interventions A 3-session social learning and cognitive behavioral therapy intervention or an education and support intervention. Main outcome measures Child symptoms and pain coping responses were monitored using standard instruments, as was parental response to child pain behavior. Data were collected at baseline and after treatment (1 week and 3, 6, and 12 months after treatment). This article reports the 12-month data. Results Relative to children in the education and support group, children in the social learning and cognitive behavioral therapy group reported greater baseline to 12-month follow-up decreases in gastrointestinal symptom severity (estimated mean difference = -0.36, CI = -0.63, -0.01) and greater improvements in pain coping responses (estimated mean difference = 0.61, CI = 0.26, 1.02). Relative to parents in the education and support group, parents in the social learning and cognitive behavioral therapy group reported greater baseline to 12-month decreases in solicitous responses to their child's symptoms (estimated mean difference = -0.22, CI = -0.42, -0.03) and greater decreases in maladaptive beliefs regarding their child's pain (estimated mean difference = -0.36, CI = -0.59, -0.13). Conclusions Results suggest long-term efficacy of a brief intervention to reduce parental solicitousness and increasing coping skills. This strategy may be a viable alternative for children with functional abdominal pain. Trial registration ClinicalTrials.gov Identifier #NCT00494260 PMID:23277304

  10. [Patients with upper abdominal pain and echographically-proven gallstones: start with expectative management].

    PubMed

    van der Vlies, C H; Keulemans, Y C A; Gouma, D J; Boermeester, M A

    2007-07-21

    Three patients, two women aged 33 and 75 years and a 62-year-old man, presented with gallstones and upper abdominal pain due to functional dyspepsia, chronic constipation, and oesophageal spasm, respectively. After a period of watchful waiting, the first patient insisted on having a cholecystectomy, but her complaints persisted. In the second patient, the complaints disappeared after treatment with a bulking agent and magnesium oxide. The third patient received medication as well: a proton-pump inhibitor, prokinetic agents, a calcium antagonist and Helicobacter eradication, and recovered. The presence of gallstones is relatively easy to assess by ultrasound imaging, but the decision whether abdominal symptoms are related to gallbladder stones remains a diagnostic challenge for the clinician. The key question for the family practitioner, gastroenterologist and surgeon is which patients with upper abdominal pain and proven gallbladder stones might benefit from a cholecystectomy. The patients described illustrate that upper abdominal pain is not invariably related to symptomatic gallbladder disease. The published evidence supports initial watchful waiting with additional diagnostic investigation, and cholecystectomy only later if judged to be necessary. PMID:17727179

  11. Clinical Scoring for Diagnosis of Acute Lower Abdominal Pain in Female of Reproductive Age

    PubMed Central

    Yamada, Sirikan; Suntornlimsiri, Watcharin; Smuthtai, Waratsuda

    2013-01-01

    Background. Obstetrics and gynecological conditions (OB-GYNc) are difficult to be differentiated from appendicitis in young adult females presenting with acute lower abdominal pain. Timely and correct diagnosis is clinically challenging. Method. A retrospective data analysis was performed on 542 female patients who were admitted to a tertiary care hospital with a chief complaint of acute lower abdominal pain. Diagnostic indicators of appendicitis and OB-GYNc were identified by stepwise multivariable polytomous logistic regression. Diagnostic performances of the scores were tested. Result. The developed clinical score is comprised of (1) guarding or rebound tenderness, (2) pregnancy, (3) sites of abdominal tenderness, (4) leukocytosis, (5) peripheral neutrophils ?75%, and (6) presence of diarrhea. For diagnosis of appendicitis, the area under the ROC curve was 0.8696, and the sensitivity and specificity were 89.25% and 70.00%. For OB-GYNc, the corresponding values were 0.8450, 66.67%, and 94.85%, respectively. Conclusion. The clinical scoring system can differentiate the diagnosis of acute lower abdominal pain in young adult females. Time spent for diagnosis at the emergency room may be shortened, and the patients would be admitted to the appropriate departments in less time. PMID:24396602

  12. Acute Abdominal Pain after Intercourse: Adrenal Hemorrhage as the First Sign of Metastatic Lung Cancer

    PubMed Central

    Packer, Clifford D.

    2014-01-01

    Although the adrenal glands are a common site of cancer metastases, they are often asymptomatic and discovered incidentally on CT scan or autopsy. Spontaneous adrenal hemorrhage associated with metastatic lung cancer is an exceedingly rare phenomenon, and diagnosis can be difficult due to its nonspecific symptoms and ability to mimic other intra-abdominal pathologies. We report a case of a 65-year-old man with a history of right upper lobectomy seven months earlier for stage IB non-small cell lung cancer who presented with acute abdominal pain after intercourse. CT scan revealed a new right adrenal mass with surrounding hemorrhage, and subsequent FDG-PET scan confirmed new metabolic adrenal metastases. The patient's presentation of abdominal pain and adrenal hemorrhage immediately after sexual intercourse suggests that exertion, straining, or increased intra-abdominal pressure might be risk factors for precipitation of hemorrhage in patients with adrenal metastases. Management includes pain control and supportive treatment in mild cases, with arterial embolization or adrenalectomy being reserved for cases of severe hemorrhage. PMID:25126096

  13. Prospective Diary Evaluation of Unexplained Abdominal Pain and Bowel Dysfunction: A Population-Based Colonoscopy Study

    Microsoft Academic Search

    Susanna A. Walter; Lars Kjellström; Nicholas J. Talley; Anna Nixon Andreasson; Henry Nyhlin; Lars Agréus

    2011-01-01

    Introduction  Diagnostic criteria for irritable bowel syndrome (IBS) have not been validated by prospective symptom diary. We investigated\\u000a the bowel patterns in community subjects with and without non-organic abdominal pain, and compared the symptoms with subjects\\u000a fulfilling the Rome II criteria (IBS).\\u000a \\u000a \\u000a \\u000a \\u000a Methods  From the Swedish population register, a random sample completed an abdominal symptom questionnaire. Responders were subsequently\\u000a invited for a

  14. Functional Abdominal Pain Patient Subtypes in Childhood Predict Functional Gastrointestinal Disorders with Chronic Pain and Psychiatric Comorbidities in Adolescence and Adulthood

    PubMed Central

    Walker, Lynn S.; Sherman, Amanda L.; Bruehl, Stephen; Garber, Judy; Smith, Craig A.

    2012-01-01

    Although pediatric functional abdominal pain (FAP) has been linked to abdominal pain later in life, childhood predictors of long-term outcomes have not been identified. This study evaluated whether distinct FAP profiles based on patterns of pain and adaptation in childhood could be identified and whether these profiles predicted differences in clinical outcomes and central sensitization (wind-up) on average 9 years later. In 843 pediatric FAP patients, cluster analysis was used to identify subgroups at initial FAP evaluation based on profiles of pain severity, gastrointestinal (GI) and non-GI symptoms, pain threat appraisal, pain coping efficacy, catastrophizing, negative affect, and activity impairment. Three profiles were identified: High Pain Dysfunctional, High Pain Adaptive, and Low Pain Adaptive. Logistic regression analyses controlling for age and sex showed that, compared to pediatric patients with the Low Pain Adaptive profile, those with the High Pain Dysfunctional profile were significantly more likely at long-term follow-up to meet criteria for pain-related functional gastrointestinal disorder (FGID) (OR: 3.45; CI: 1.95–6.11), FGID with comorbid non-abdominal chronic pain (OR: 2.6; CI:1.45–4.66), and FGID with comorbid anxiety or depressive psychiatric disorder (OR: 2.84; CI: 1.35–6.00). Pediatric patients with the High Pain Adaptive profile had baseline pain severity comparable to the High Pain Dysfunctional profile, but had outcomes as favorable as the Low Pain Adaptive profile. In laboratory pain testing at follow-up, High Pain Dysfunctional patients exhibited significantly greater thermal wind-up than Low Pain Adaptive patients, suggesting that a subgroup of FAP patients has outcomes consistent with widespread effects of heightened central sensitization. PMID:22721910

  15. Adrenal pseudocyst as a cause of postpartum abdominal pain.

    PubMed

    Zanghì, A; Di Vita, M; Lo Menzo, E; Fiorica, F; Cavallaro, A; Cimino, L; Piccolo, G; Palmucci, S; Cappellani, A

    2012-01-01

    Among adrenal masses only 0.06% to 0.18% are cysts and among them, pseudocysts are the second (39%) most common lesions. Due to the increased use of imaging studies their incidence seems to have increased. Most of these lesions are incidentally found during radiologic investigation or at the time of autopsy, and only rarely they are detected in pregnant women. The latter scenario warrants emergency surgery, due to the risk of rupture. We present a case of a 39-years old woman presenting with unrelenting left flank pain due to a large adrenal pseudocyst soon after her first delivery. Four months after, she presented to our surgical division for persistent pain and anemia so underwent an extensive work up that showed a large pseudocystic mass (8 x 8 cm ) of the left adrenal gland. Once the neoplastic and parasitic etiology of the lesion were excluded, she underwent uneventful laparoscopic adrenalectomy. She was discharged home three days postoperatively. This case is the 13th case in the English literature and at the same time is the first case of adrenal pseudocyst occurred four months after delivery. PMID:23099983

  16. A 33-year-old Haitian immigrant with 7 months of abdominal pain and progressive distension.

    PubMed

    Farhadian, Shelli; Shenoi, Sheela V; Villanueva, Merceditas S

    2014-01-01

    We report a case of a 33-year-old previously healthy Haitian immigrant with a 7-month history of abdominal pain, fever and ascites. He had a history of positive tuberculin skin test but never underwent treatment for latent tuberculosis (TB) infection. Initial examination showed abdominal distension. Abdominal CT scan showed mild ascites, abnormal soft tissue in the greater omentum and small bowel mesentery, retroperitoneal adenopathy, peritoneal thickening and dilated loops of small bowel. Paracentesis and thoracentesis were initially non-diagnostic. HIV testing was negative. The differential diagnosis included lymphoma and TB peritonitis. The omental mass was biopsied under ultrasound guidance, and histopathology revealed non-necrotising granulomas. Sputum cultures and omental biopsy cultures subsequently grew Mycobacterium tuberculosis, and a diagnosis was made of pulmonary TB with TB peritonitis. The patient responded well to the initiation of anti-TB treatment. PMID:25008341

  17. Abdominal pain and dysuria in pregnancy: urinary tract infection or life threatening haemorrhage?

    PubMed

    Lamyman, M J; Connor, H; Brown, R

    2005-12-01

    This report describes the case of a 27 year old woman presenting at 19 weeks' gestation with epigastric pain and dysuria. Initially diagnosed with a urinary tract infection, she re-presented 10 days later with acute abdominal pain and haemoperitoneum. The diagnosis of placenta percreta was not made until laparotomy. This case highlights placenta percreta as a rare but serious complication of pregnancy that may become increasingly frequent as the rates of caesarean delivery rise. Early diagnosis, close monitoring, and prompt surgical management are essential as massive blood loss can occur. This can be challenging, as clinical presentation can be unusual. PMID:16299219

  18. Perforated jejunal diverticula- a rare cause of acute abdominal pain: a case report.

    PubMed

    Akbari, Mohammad Esmail; Atqiaee, Khashayar; Lotfollahzadeh, Saran; Moghadam, Amir Naser Jadbbaeey; Sobhiyeh, Mohammad Reza

    2013-01-01

    Jejunal diverticula have a prevalence of approximately 1% in the general population. Perforation of jejunal diverticulum is a rare. Clinically this diagnosis may be easily confused with other causes of an acute abdomen. In the article, we discuss a 74-year-old man with a 2-day history of constipation and left-sided abdominal pain. The day before admission he developed an abrupt exacerbation his symptoms with pain localized to periumbilical and left lower quadrant. An abdominal computed tomography scan revealed soft tissue stranding within the left upper quadrant, bilateral plural effusions , larger on the left, an opacity with the right and left pulmonary lobes and polypoid lesion with in stomach. Physical examination revealed left upper quadrant fullness. An emergency laparotomy was carried out. This revealed multiple jejunal diverticula, one of which had perforated 40 centimeters distal to the ligament of Treitz. PMID:24834264

  19. Changing Prevalence of Helicobacter pylori Infections in Korean Children with Recurrent Abdominal Pain

    PubMed Central

    Jang, Kyung Mi; Choe, Jae Young; Hong, Suk Jin; Park, Hyo Jung; Chu, Mi Ae; Cho, Seung Man; Kim, Jung Mi

    2015-01-01

    Purpose The aim of this study is to investigate the changing prevalence rate of Helicobacter pylori infection in children, of different age groups, with recurrent abdominal pain over a 10-year period. Methods Children with recurrent abdominal pain who visited the pediatric outpatient clinic at university hospital were screened for H. pylori. Children were divided into 3 age categories of 4-5, 6-11, and 12-16 years. To study the changes in the annual prevalence rates of H. pylori infection, the study period was divided into 3 time periods: 2004-2007, 2008-2010, and 2011-2014. Urea breath test was performed for all children aged 4-16 years, with a cut-off value of 4.0‰ for children aged ?6 years and 7‰ for children aged <6 years. Results A total of 2,530 children (1,191 boys) with a mean age of 10.0±3.0 years (range, 4.0-16.9 years) were included in the study. The total prevalence of H. pylori infection was 7.4% (187/2,530). The prevalence rate of H. pylori infection in children with recurrent abdominal pain was 8.0% (70/873) in 2004-2007, 7.7% (51/666) in 2008-2010, and 6.7% (66/991) in the 2011-2014. Nevertheless, a significant difference was observed in the prevalence rate between children <12 years old and ?12 years of age (p=0.018). Conclusion The prevalence of H. pylori infection in Korean children with recurrent abdominal pain was 7.4%, showing no significant decrease in the last 11 years; however, the prevalence rate in children <12 years old was significantly lower than that in those ?12 years old.

  20. An unusual cause of abdominal pain in an HIV-positive man.

    PubMed

    Saing, Chit; Yoganathan, Kathir G

    2015-01-01

    We report a case of an HIV-positive man on antiretroviral therapy (ART) who developed abdominal pain due to acute-on-chronic intestinal ischaemia secondary to superior mesenteric vein thrombosis (SMVT) requiring emergency surgery. He was found to have persistently low levels of protein C on thrombophilia screening. To the best of our knowledge, the association linking SMVT to protein C deficiency in an HIV-infected patient has never been reported in the literature. PMID:25819818

  1. A Minimal Contact Cognitive-Behavioral Intervention for Abdominal Pain-Related Functional Gastrointestinal Disorders: Pilot-Study of "Gutstrong".

    E-print Network

    Wassom, Matthew Craig

    2008-08-21

    disorders make up the majority of those with abdominal pain and are a set of conditions resulting from complex interactions between physiological and psychological factors. Psychological treatments such as cognitive-behavioral therapy have been shown... to be largely effective for children and adolescents with recurrent abdominal pain. However, barriers to the use of this treatment are related to accessibility, the cost and time commitment of therapy, and the ambivalence of families to pursue psychological...

  2. Pain pressure threshold algometry of the abdominal wall in healthy women

    PubMed Central

    Montenegro, M.L.L.S.; Braz, C.A.; Mateus-Vasconcelos, E.L.; Rosa-e-Silva, J.C.; Candido-dos-Reis, F.J.; Nogueira, A.A.; Poli-Neto, O.B.

    2012-01-01

    The objective of this study was to determine the inter- and intra-examiner reliability of pain pressure threshold algometry at various points of the abdominal wall of healthy women. Twenty-one healthy women in menacme with a mean age of 28 ± 5.4 years (range: 19-39 years) were included. All volunteers had regular menstrual cycles (27-33 days) and were right-handed and, to the best of our knowledge, none were taking medications at the time of testing. Women with a diagnosis of depression, anxiety or other mood disturbances were excluded. Women with previous abdominal surgery, any pain condition or any evidence of inflammation, hypertension, smoking, alcoholism, or inflammatory disease were also excluded. Pain perception thresholds were assessed with a pressure algometer with digital traction and compression and a measuring capacity for 5?kg. All points were localized by palpation and marked with a felt-tipped pen and each individual was evaluated over a period of 2 days in two consecutive sessions, each session consisting of a set of 14?point measurements repeated twice by two examiners in random sequence. There was no statistically significant difference in the mean pain threshold obtained by the two examiners on 2 diferent days (examiner A: P = 1.00; examiner B: P = 0.75; Wilcoxon matched pairs test). There was excellent/good agreement between examiners for all days and all points. Our results have established baseline values to which future researchers will be able to refer. They show that pressure algometry is a reliable measure for pain perception in the abdominal wall of healthy women. PMID:22527127

  3. Do patients with acute abdominal pain wait unduly long for analgesia?

    PubMed

    Tait, I S; Ionescu, M V; Cuschieri, A

    1999-06-01

    A prospective audit of 100 emergency admissions was carried out to determine local surgical practice for analgesia administration in patients with acute abdominal pain. The main outcome measure investigated was waiting time for analgesia and how this was influenced by (i) severity of pain, (ii) clinical diagnosis, (iii) clinical setting. The data were correlated with the results of a questionnaire on timing of analgesia. Forty percent of patients received analgesia within 1 h, 17% between 1-2 h, and 43% 2-22 h after admission. Mean waiting time was 2.3 h with severe pain (n = 84) vs. 6.3 h with moderate pain (n = 16, p < 0.0001, Mann-Whitney). Clinical diagnosis did not influence timing of analgesia. Fifty-seven per cent received analgesia in the Accident and Emergency (A&E) department with a mean wait of 60 min, whereas 43% admitted to the ward without analgesia in the A&E department waited an average of 5.7 h for pain medication (p < 0.0001; Mann-Whitney U-test). This was at variance with local surgical opinion that favoured early analgesia administration (yes-88%), in the absence of a firm diagnosis (yes-79%), although 38% stated that analgesia might mask physical signs. In conclusion, a substantial cohort of patients with acute abdominal pain (43%) wait too long for analgesia. Delays are due to omission of analgesia in A&E, and reluctance of junior staff to administer analgesia for fear of masking physical signs. Clinical guidelines for pain medication in acute surgical emergencies are warranted. PMID:10372490

  4. Abdominal pain in an adult with Type 2 diabetes: A case report

    PubMed Central

    Panagoulias, George; Tentolouris, Nicholas; Ladas, Spiros S

    2008-01-01

    Introduction Chronic abdominal pain (CAP) may be a manifestation of diseases involving many intra-abdominal organs. Beside diseases affecting subjects without diabetes mellitus, diabetic patients may have CAP due to diabetes-related complications like neuritis, motor diseases of the gastrointestinal tract and autonomic dysfunction. Atherosclerosis is 2–4 times more common in patients with diabetes and affects mainly carotid, coronary, iliac and lower limb arteries as well as aorta. Another less common complication is chronic mesenteric ischemia (CMI, intestinal angina), caused by atherosclerotic obstruction of the celiac artery and its branches and results in episodic or constant intestinal hypoperfusion. Case presentation We present a case of a diabetic patient with CMI in whom the diagnosis was delayed by almost 5 years. The dominant symptoms were crampy abdominal postprandial pain, anorexia, changes in bowel habits and cachexia. Conventional angiography revealed significant stenosis of the celiac artery and complete obstruction of the inferior mesenteric artery. Noteworthy, no significant stenoses in carotids or limbs' arteries were found. Revascularization resulted in clinical improvement 1 week post-intervention. Conclusion CAP in patients with diabetes may be due to CMI. The typical presentation is crampy postprandial abdominal pain in a heavy smoker male patient with long-standing diabetes, accompanied by anorexia, changes in bowel habits and mild to moderate weight loss. At least two of the three main splanchnic arteries must be significantly occluded in order CMI to be symptomatic. The diagnostic procedure of choice is conventional angiography and revascularization of the occluded arteries is the radical treatment. PMID:18798976

  5. Antinociceptive effects of novel melatonin receptor agonists in mouse models of abdominal pain

    PubMed Central

    Chen, Chunqiu; Fichna, Jakub; Laudon, Moshe; Storr, Martin

    2014-01-01

    AIM: To characterize the antinociceptive action of the novel melatonin receptor (MT) agonists, Neu-P11 and Neu-P12 in animal models of visceral pain. METHODS: Visceral pain was induced by intracolonic (ic) application of mustard oil or capsaicin solution or by intraperitoneal (ip) administration of acetic acid. Neu-P11, Neu-P12, or melatonin were given ip or orally and their effects on pain-induced behavioral responses were evaluated. To identify the receptors involved, the non-selective MT1/MT2 receptor antagonist luzindole, the MT2 receptor antagonist 4-P-PDOT, or the ?-opioid receptor antagonist naloxone were injected ip or intracerebroventricularly (icv) prior to the induction of pain. RESULTS: Orally and ip administered melatonin, Neu-P11, and Neu-P12 reduced pain responses in a dose-dependent manner. Neu-P12 was more effective and displayed longer duration of action compared to melatonin. The antinociceptive effects of Neu-P11 or Neu-P12 were antagonized by ip or icv. administered naloxone. Intracerebroventricularly, but not ip administration of luzindole or 4-P-PDOT blocked the antinociceptive actions of Neu-P11 or Neu-P12. CONCLUSION: Neu-P12 produced the most potent and long-lasting antinociceptive effect. Further development of Neu-P12 for future treatment of abdominal pain seems promising. PMID:24574803

  6. A two-year old boy with recurrent bouts of acute abdominal pain.

    PubMed

    Blom, H; Bochner, A; Vervloessem, D; Desimpelaere, J; Devière, J; Veereman-Wauters, G

    2010-01-01

    In a small number of patients with pancreas divisum (with stenotic minor papilla) a relative obstruction to pancreatic exocrine secretory flow results in pancreatitis. We report a 2-year-old boy presenting with recurrent bouts of abdominal pain. The diagnosis of acute pancreatitis was made based on blood biochemistry results. Ultrasound, computed tomography and magnetic resonance imaging showed several abdominal pseudocysts, peritoneal exsudate and confirmed pancreatitis but initially failed to reveal the aetiology. Ascites and cysts contained pancreatic enzymes. After weeks of combined conservative and surgical treatment, a magnetic resonance cholangiopancreaticography with secretin, showed a pancreas divisum with a cyst between the ducts of Santorini and Wirsung. Based on these findings, two endoscopic papillotomies (minor and major papilla) were performed. Three years follow-up was uneventful. In a child with recurrent pancreatitis or pancreatitis with chronic recurrent abdominal pain it is crucial to search aggressively for congenital abnormalities, including pancreas divisum. Secretin-enhanced magnetic resonance cholangiopancreaticography or diffusion-weighted magnetic resonance imaging is a valuable diagnostic tool for visualizing pancreatic duct anatomy. PMID:21299165

  7. Strongyloides stercoralis is a cause of abdominal pain, diarrhea and urticaria in rural Cambodia

    PubMed Central

    2013-01-01

    Background We document clinical manifestations of 21 patients heavily infected with S. stercoralis (more than 250 larvae in a single Baermann test) from a community in rural Cambodia, both before and three weeks after ivermectin (200 ?g/kg BW, single oral dose) treatment. Findings Out of 21 patients, 20 (95.2%), 18 (85.7%) and 14 (66.7%) reported frequent abdominal pain, diarrhea and periods of sensation of itching, respectively, during the previous six months; epigastric (11, 55.0%) and peri-umbilical (13, 65.0%) pains were most frequent. Five patients (23.8%) reported having experienced urticaria the week preceding the examination. One patient suffered from extended urticaria. Three weeks after treatment, most symptoms had been almost entirely resolved. Conclusions In rural communities of Cambodia, strongyloidiasis with high parasite load is endemic. It is associated with substantial symptoms and clinical signs, particularly abdominal pain, diarrhea and urticaria. Access to adequate diagnosis and treatment is a pressing issue that needs attention. PMID:23688049

  8. Spinal cord stimulation for intractable chronic upper abdominal pain: a case report of the first patient in New Zealand.

    PubMed

    Al-Mahrouqi, Haitham; Munro, Zea; Acland, Richard H; MacFarlane, Martin R

    2012-12-14

    We present the first patient in New Zealand to undergo Spinal Cord Stimulation (SCS) for intractable upper abdominal pain. The patient was a 53-year-old man with a 20-year history of debilitating upper abdominal pain associated with chronic pancreatitis secondary to pancreatic divisum. Prior to the SCS, he was prescribed 680 mg of morphine sulphate equi-analgesia a day. Despite the intense analgesia, he still suffered monthly attacks of upper abdominal pain requiring hospitalisation. Nine months after implanting a Spinal Cord Stimulator, the monthly attacks ceased, his background pain was effectively controlled and the need for opioids decreased to 510 mg of morphine sulphate equi-analgesia a day. PMID:23321890

  9. Effects of gabapentin on pain and opioid consumption after abdominal hysterectomy

    PubMed Central

    Frouzanfard, Fatemeh; Fazel, Mohammed Reza; Abolhasani, Azadeh; Fakharian, Esmaeil; Mousavi, Golmabas; Moravveji, Alireza

    2013-01-01

    BACKGROUND Postoperative pain is an important factor affecting anesthesia and surgery. OBBJECTIVES: The present study assessed the effects of 1200 mg gabapentin, an anticonvulsant drug that acts through voltage-dependent calcium channels, for the control of postoperative pain in patients undergoing abdominal hysterectomy. METHODS: Fifty patients undergoing hysterectomy were enrolled in the present study. Subjects received either 1200 mg gabapentin or placebo 2 h before surgery. The amount of morphine consumption and level of postoperative pain at 2 h, 6 h, 12 h and 24 h after surgery were measured. RESULTS: There were no significant differences in age, duration of surgery and anesthesia, or body mass index between the two groups. The mean intensity of pain in the gabapentin group was significantly lower than in the placebo group. The mean amount of morphine used in the placebo group (5.2±2.8 mg) was significantly higher than in gabapentin group (1.2±0.29 mg; P=0.001). Nausea and vomiting in the placebo group was more common than in the gabapentin group (P=0.001). The time interval for initial ambulation after surgery was significantly shorter in the gabapentin group (12.24±2.18 h) compared with the placebo group (15±3.61 h; P=0.002). CONCLUSION: 1200 mg gabapentin reduced postoperative pain and the need for opioids, and enabled earlier ambulation of the patient. Significant side effects were not observed. PMID:23662292

  10. Abdominal pain.

    PubMed

    Banting, Joshua; Meriano, Tony

    2015-01-01

    The series objective is to review various clinical conditions/presentations, including the latest evidence on management, and to dispel common myths. In the process, core knowledge and management principles are enhanced. A clinical case will be presented. Cases will be drawn from real life but phrased in a context that is applicable to the Special Operations Forces (SOF) or tactical emergency medical support (TEMS) environment. Details will be presented in such a way that the reader can follow along and identify how they would manage the case clinically depending on their experience and environment situation. Commentary will be provided by currently serving military medical technicians. The medics and author will draw on their SOF experience to communicate relevant clinical concepts pertinent to different operational environments including SOF and TEMS. Commentary and input from active special operations medical technicians will be part of the feature. PMID:25770809

  11. Integrative treatment approaches: family satisfaction with a multidisciplinary paediatric Abdominal Pain Clinic

    PubMed Central

    Schurman, Jennifer Verrill; Friesen, Craig A

    2010-01-01

    Objectives To assess patient and family satisfaction with evaluation received through a multidisciplinary paediatric Abdominal Pain Clinic (APC) staffed by a paediatric gastroenterologist and a paediatric psychologist as compared to a traditional gastroenterology clinic (GI) staffed by a paediatric gastroenterologist only. Methods Two hundred and ninety-eight families (145 APC, 153 GI) with a child or adolescent aged 8–17 years seen for initial evaluation of a chronic abdominal pain completed an anonymous survey to assess understanding of the treatment recommendations made, intent to follow through with various treatment recommendations, and the overall level of satisfaction with the evaluation service provided. Family perceptions of strengths and challenges of the APC evaluation process also were explored. Results APC families reported being prescribed adjunctive mental health and other therapies at significantly higher rates than GI families, while the rates of medication were comparable. APC families also reported significantly greater receptivity to beginning the treatments prescribed and higher levels of overall satisfaction with the evaluation process. The contribution of integrated medical and psychological perspectives frequently was identified as a strength of the APC evaluation process. Challenges identified for the APC evaluation were few and focused on issues related to paperwork and scheduling issues. Conclusions Integrative care approaches to the evaluation of paediatric abdominal pain appear well accepted by families, yielding high levels of satisfaction, and enhance receptivity to treatment recommendations. Integrative care starting at the time of first evaluation may be particularly well-tailored to enhance outcomes, reduce health care utilization, and yield financial savings within this population. PMID:20922066

  12. Abdominal pain, diarrhea, constipation-which symptom is more indispensable to have a colonoscopy?

    PubMed Central

    Cai, Jia; Yuan, Zhe; Zhang, Shujun

    2015-01-01

    Background: Doctors perform colonoscopies when presented with various symptoms, including unexplained weight loss, rectal bleeding, changes in bowel habits, however many other symptoms such as abdominal pain, diarrhea and constipation may be more popular in outpatient department. As a result, we want to evaluate the three symptoms which is more need to have a colonoscopy. Abdominal pain, diarrhea and constipation are the main reasons for patients to visit the outpatient department of gastroenterology. And the colonoscopy is regularly recommended for outpatients with the above symptoms in China. The aim of this study was to evaluate the value of colonoscopy on the diagnosis of each single symptom of the three above and answer the question of my title-which symptom is more indispensable to have a colonoscopy? Methods: Colonoscopic findings of 580 outpatients with a single of these three common lower gastrointestinal symptoms were systematically analyzed in retrospect. Results: In this study, no significant difference was found in the positive rate of colon polyps, cancer and ulcerative colitis among these three groups divided by symptoms. The incidence of colon polyps, cancer and colitis for the chronic abdominal pain, chronic diarrhea and constipation group are 20.8%, 57.1%, 42.9% respectively. The incidence of colon polyps and cancer increases with age. Among the age groups 13-39 years old, 40-59 years and > 60 years, the incidence is 7.9%, 13.6%, 22.4% respectively. There is no significant difference in the incidence of colon polyps and colon cancer in our groups of symptoms. Conclusion: The results show the prevailing opinion that the indications of colonoscopy just refer to symptom and physical sign nowadays in China is inappropriate and it is best to take a full consideration of patient’s age, auxiliary examinations, family diseases history and other factors. PMID:25755799

  13. 73-year-old woman with abdominal pain in the right lower quadrant

    SciTech Connect

    Bond, J.R.

    1987-03-20

    A 73-year-old woman presented with a six-day history of abdominal pain that had started in the epigastrium, but recently had become more intense in the right lower quadrant. Peptic ulcer had been diagnosed three years prior to presentation and had been managed medically. On physical examination, epigastric tenderness as well as guarding and rebound tenderness in the right lower quandrant were present. Mild leukocytosis was reported. Computed tomography demonstrated a 5-cm retrocecal mass with low attenuation (fluid content) surrounded by an irregularly thickened uncalcified wall. Multiple areas of tissue debris were seen extending into the mass, but no true separation was present.

  14. Abdominal Implantation of Testicles in the Management of Intractable Testicular Pain in Fournier Gangrene

    PubMed Central

    Chan, Cyrus C.; Shahrour, Khaled; Collier, Ronald D.; Welch, Marlene; Chang, Shiliang; Williams, Mallory

    2013-01-01

    Fournier gangrene (FG) is a necrotizing soft tissue infection involving the superficial and fascial planes of the perineum. In many cases of FG, debridement of the scrotum is necessary, leaving definitive management of the exposed testicles a significant surgical challenge. Frequent incidental trauma to the testicles can cause severe pain, especially in laborers. Practical surgical solutions are few and not well detailed. Various options exist, including creating a neoscrotum with adjacent thigh tissue, split-thickness skin grafts (STSGs), or even creating a subcutaneous thigh pocket. We describe a case of abdominal implantation of bilateral testicles for persistent testicular pain in a case where STSGs did not provide adequate protection, adjacent thigh skin was not available for creation of a neoscrotum, and significant cord contracture occurred. We detail the advantages and disadvantages of the commonly described techniques, including this approach, and how in select individuals this may be a suitable alternative. PMID:24229025

  15. Bilateral Simultaneous Femoral Neck Fracture Mimicking Abdominal Pain in a Cerebral Palsy Patient

    PubMed Central

    Mariani, P.; Buttaro, M.; Comba, F.; Zanotti, E.; Ali, P.; Piccaluga, F.

    2014-01-01

    Simultaneous bilateral femoral neck fractures are unusual lesions, generally associated with an underlying condition which causes impaired bone mineralization, triggered by an increased bone stress. We present a 24-year-old cerebral palsy patient, who was previously evaluated in another institution due to inability to walk, interpreted as abdominal pain. No alteration in blood analysis or abdominal X-rays was found. As no response to treatment was observed, a new abdominal X-ray was taken, which incidentally depicted bilateral medial femoral neck fracture. He was referred to our practice after a resection arthroplasty was offered in another institution. After admission, bilateral one-stage THA was performed. Several reports emphasize bone disease as a major precipitating factor, and there is an increased incidence of hip fractures in chronic epilepsy, renal osteodystrophy, and chronic steroid use. Femoral head resection has been proven to be effective in immobilized patients, whereas this was not a reasonable option in this patient who presented walking ability. Despite the treatment election, primary care physicians should be aware of and alert to the possibility of fractures in patients with neurological disorders and calcium metabolism alterations. Late diagnosis of orthopedic injuries in this type of patients may lead to permanent disability. PMID:25506016

  16. Bilateral simultaneous femoral neck fracture mimicking abdominal pain in a cerebral palsy patient.

    PubMed

    Mariani, P; Buttaro, M; Comba, F; Zanotti, E; Ali, P; Piccaluga, F

    2014-01-01

    Simultaneous bilateral femoral neck fractures are unusual lesions, generally associated with an underlying condition which causes impaired bone mineralization, triggered by an increased bone stress. We present a 24-year-old cerebral palsy patient, who was previously evaluated in another institution due to inability to walk, interpreted as abdominal pain. No alteration in blood analysis or abdominal X-rays was found. As no response to treatment was observed, a new abdominal X-ray was taken, which incidentally depicted bilateral medial femoral neck fracture. He was referred to our practice after a resection arthroplasty was offered in another institution. After admission, bilateral one-stage THA was performed. Several reports emphasize bone disease as a major precipitating factor, and there is an increased incidence of hip fractures in chronic epilepsy, renal osteodystrophy, and chronic steroid use. Femoral head resection has been proven to be effective in immobilized patients, whereas this was not a reasonable option in this patient who presented walking ability. Despite the treatment election, primary care physicians should be aware of and alert to the possibility of fractures in patients with neurological disorders and calcium metabolism alterations. Late diagnosis of orthopedic injuries in this type of patients may lead to permanent disability. PMID:25506016

  17. Acute right lower abdominal pain in women of reproductive age: Clinical clues

    PubMed Central

    Hatipoglu, Sinan; Hatipoglu, Filiz; Abdullayev, Ruslan

    2014-01-01

    AIM: To study possible gynecological organ pathologies in the differential diagnosis of acute right lower abdominal pain in patients of reproductive age. METHODS: Following Clinical Trials Ethical Committee approval, the retrospective data consisting of physical examination and laboratory findings in 290 patients with sudden onset right lower abdominal pain who used the emergency surgery service between April 2009 and September 2013, and underwent surgery and general anesthesia with a diagnosis of acute appendicitis were collated. RESULTS: Total data on 290 patients were obtained. Two hundred and twenty-four (77.2%) patients had acute appendicitis, whereas 29 (10%) had perforated appendicitis and 37 (12.8%) had gynecological organ pathologies. Of the latter, 21 (7.2%) had ovarian cyst rupture, 12 (4.2%) had corpus hemorrhagicum cyst rupture and 4 (1.4%) had adnexal torsion. Defense, Rovsing’s sign, increased body temperature and increased leukocyte count were found to be statistically significant in the differential diagnosis of acute appendicitis and gynecological organ pathologies. CONCLUSION: Gynecological pathologies in women of reproductive age are misleading in the diagnosis of acute appendicitis. PMID:24744594

  18. Caesarean Section: Could Different Transverse Abdominal Incision Techniques Influence Postpartum Pain and Subsequent Quality of Life? A Systematic Review

    PubMed Central

    Gizzo, Salvatore; Andrisani, Alessandra; Noventa, Marco; Di Gangi, Stefania; Quaranta, Michela; Cosmi, Erich; D’Antona, Donato; Nardelli, Giovanni Battista; Ambrosini, Guido

    2015-01-01

    The choice of the type of abdominal incision performed in caesarean delivery is made chiefly on the basis of the individual surgeon’s experience and preference. A general consensus on the most appropriate surgical technique has not yet been reached. The aim of this systematic review of the literature is to compare the two most commonly used transverse abdominal incisions for caesarean delivery, the Pfannenstiel incision and the modified Joel-Cohen incision, in terms of acute and chronic post-surgical pain and their subsequent influence in terms of quality of life. Electronic database searches formed the basis of the literature search and the following databases were searched in the time frame between January 1997 and December 2013: MEDLINE, EMBASE Sciencedirect and the Cochrane Library. Key search terms included: “acute pain”, “chronic pain”, “Pfannenstiel incision”, “Misgav-Ladach”, “Joel Cohen incision”, in combination with “Caesarean Section”, “abdominal incision”, “numbness”, “neuropathic pain” and “nerve entrapment”. Data on 4771 patients who underwent caesarean section (CS) was collected with regards to the relation between surgical techniques and postoperative outcomes defined as acute or chronic pain and future pregnancy desire. The Misgav-Ladach incision was associated with a significant advantage in terms of reduction of post-surgical acute and chronic pain. It was indicated as the optimal technique in view of its characteristic of reducing lower pelvic discomfort and pain, thus improving quality of life and future fertility desire. Further studies which are not subject to important bias like pre-existing chronic pain, non-standardized analgesia administration, variable length of skin incision and previous abdominal surgery are required. PMID:25646621

  19. Acute Abdominal Pain as a Result of a Ruptured Hematosalpinx: A Rare Complication of an Unusual Müllerian Anomaly

    Microsoft Academic Search

    C. L. Diehl; L. P. Gavrilova-Jordan; C. C. Coddington

    2009-01-01

    Case ReportA 15-year-old virgin Caucasian female presented to the emergency room with a 40-hour history of acute left lower quadrant abdominal pain and nausea. Evaluation suggested a left pelvic kidney with obstructed ureter being the etiology. Her pain continued to escalate so further workup with laparoscopy was performed. This demonstrated a left pelvic sidewall hemi uterus with ruptured hematosalpinx. This

  20. Pain symptoms and stooling patterns do not drive diagnostic costs for children with functional abdominal pain and irritable bowel syndrome in primary or tertiary care

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The objectives of this study were to (1) compare the cost of medical evaluation for children with functional abdominal pain or irritable bowel syndrome brought to a pediatric gastroenterologist versus children who remained in the care of their pediatrician, (2) compare symptom characteristics for th...

  1. Synbiotic containing Bacillus coagulans and fructo-oligosaccharides for functional abdominal pain in children

    PubMed Central

    Saneian, Hossein; Pourmoghaddas, Zahra; Roohafza, Hamidreza; Gholamrezaei, Ali

    2015-01-01

    Aim: We evaluated the effectiveness of a synbiotic in the treatment of childhood functional abdominal pain (FAP). Background: Probiotics are effective in the treatment of functional gastrointestinal disorders in adult patients, but there is lack of information in children. Patients and methods: Children with FAP, based on the Rome III criteria (n = 115, aged 6-18 years), were randomized to receive either synbiotic (Bacillus coagulans, Unique IS-2, 150 million spore plus FOS, 100 mg) twice daily or placebo for four weeks. Treatment response was defined as ? 2-point reduction in the 6-point self-rated pain scale or “no pain”. Physician-rated global severity and improvement were also evaluated. Patients were followed for a total of 12 weeks. Results: Eighty-eight patients completed the trial (45 with synbiotic). Response rate was higher with synbiotic than placebo after medication (60% vs. 39.5%, P = 0.044), but was not different between the two groups at week 12 (64.4% vs. 53.4%, P = 0.204). Difference between the two groups regarding the physician-rated global severity over the study period was not statistically significant (z = -1.87, P = 0.062). There was no significant difference between the two groups in physician-rated global improvement (week 4, P = 0.437; week 12, P = 0.111). Receiving synbiotic (OR 2.608, 95% CI: 1.01-6.68) and baseline pain score (OR 2.21, 95% CI: 1.19-4.10) were predictors of treatment response after medication. Conclusion: The synbiotic containing Bacillus coagulans and FOS seems to be effective in the treatment of childhood FAP. Further trials are recommended in this regard. PMID:25584177

  2. Spontaneous superior mesenteric artery (SMA) dissection: an unusual cause of abdominal pain.

    PubMed

    Watring, Nicole J; Smith, Corbett M; Stokes, Gordon K; Counselman, Francis L

    2010-11-01

    A 44-year-old woman presented to our Emergency Department with a 4-day history of severe, sharp left upper quadrant abdominal pain associated with nausea and vomiting. She had been seen 3 days prior at another Emergency Department, and had a negative work-up including a normal non-contrast computed tomography (CT) scan of the abdomen/pelvis for possible kidney stone. Vital signs were: temperature 36.3°C (97.3°F), pulse 100 beats/min, respiratory rate 18 breaths/min, and blood pressure 141/80 mm Hg. Physical examination was remarkable for marked tenderness in the left upper and middle quadrants and voluntary guarding. Bowel sounds were normal. Although laboratory studies were normal, a CT scan of the abdomen/pelvis with intravenous contrast suggested a superior mesenteric artery dissection. This was confirmed with arteriography. The clinical presentation, diagnostic evaluation, and management of superior mesenteric artery dissection are reviewed. PMID:18180132

  3. Carbohydrate digestion in congenital sucrase isomaltase deficient and recurrent abdominal pain children assesed by 13C- starch breath test

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Starches contribute about half of the food energy needs to the weaned child's diet. Malabsorption of sucrose is associated with abdominal pain, bloating and diarrhea. A genetic disorder called Congenital Sucrase-Isomaltase Deficiency (CSID) is suspected when these symptoms follow sugar ingestion and...

  4. Combined neurolytic block of celiac, inferior mesenteric, and superior hypogastric plexuses for incapacitating abdominal and\\/or pelvic cancer pain

    Microsoft Academic Search

    Takeshi Kitoh; Satoshi Tanaka; Koichi Ono; Yukihiro Ohfusa; Hiroaki Ina; Tetsutaro Otagiri

    2005-01-01

    Thirty-five patients with extensive abdominal or pelvic cancer who suffered uncontrolled, diffuse, extensive, and incapacitating pain were treated with a combination of neurolytic celiac plexus block (CPB), inferior mesenteric plexus block (IMPB), and superior hypogastric plexus block (SHGPB). The combination of neurolytic CPB, IMPB, and SHGPB was performed with alcohol, mainly using a transintervetebral disc approach. The combination neurolysis produced

  5. Early laparoscopy as a routine procedure in the management of acute abdominal pain: a review of 1,320 patients

    Microsoft Academic Search

    V. Golash; P. D. Willson

    2005-01-01

    Background: Acute abdominal pain is a common cause for presentation to the emergency room and hospital admission. Many of these patients will undergo exploration for suspected appendicitis, but in 20–35% of cases a normal appendix is found. Because of the limited access provided by the gridiron incision, a definitive diagnosis may not be found. Other patients may be treated conservatively

  6. A giant adrenal lipoma presenting in a woman with chronic mild postprandial abdominal pain: a case report

    PubMed Central

    2011-01-01

    Introduction Adrenal lipomas are rare, small, benign, non-functioning tumors, which must be histopathologically differentiated from other tumors such as myelolipomas or liposarcomas. They are usually identified incidentally during autopsy, imaging, or laparotomy. Occasionally, they may present acutely due to complications such as abdominal pain from retroperitoneal bleeding, or systemic symptoms of infection. We report a giant adrenal lipoma (to the best of our knowledge, the second largest in the literature) clinically presenting with chronic mild postprandial pain. Case presentation A 54-year-old Caucasian woman presented several times over a period of 10 years to various emergency departments complaining of long-term mild postprandial abdominal pain. Although clinical examinations were unrevealing, an abdominal computed tomography scan performed at her most recent presentation led to the identification of a large lipoma of the left adrenal gland, which occupied most of the retroperitoneal space. Myelolipoma was ruled out due to the absence of megakaryocytes, immature leukocytes, or erythrocytes. Liposarcoma was ruled out due to the absence of lipoblasts. The size of the lipoma (16 × 14 × 7 cm) is, to the best of our knowledge, the second largest reported to date. After surgical resection, our patient was relieved of her symptoms and remains healthy six years postoperatively. Conclusion Physicians should be aware that differential diagnosis of mild chronic abdominal pain in patients presenting in emergency rooms may include large adrenal lipomas. When initial diagnostic investigation is not revealing, out-patient specialist evaluation should be planned to enable appropriate further investigations. PMID:21466677

  7. Social learning contributions to the etiology and treatment of functional abdominal pain and inflammatory bowel disease in children and adults

    Microsoft Academic Search

    Rona L Levy; Shelby L Langer; William E Whitehead

    2007-01-01

    This paper reviews empirical work on cognitive and social learning contributions to the etiology and treatment of illness behavior associated with functional abdominal pain and inflammatory bowel disease. A particular emphasis is placed on randomized controlled trials, the majority of which are multi-modal in orientation, incorporating elements of cognitive behavioral therapy, social learning, and relaxation. Based on this review, we

  8. Superior mesenteric artery syndrome as a cause for recurrent abdominal pain and vomiting in a 9-year-old girl.

    PubMed

    Forsyth, James Michael; Muhammad, Karim; Mahmood, Khalid

    2015-01-01

    A 9-year-old girl was admitted under our general surgical team with 2?days of diffuse abdominal pain and vomiting. This was one of multiple admissions for similar symptoms over the past 5?years. She was feverish on admission but haemodynamically stable. On examination, she had a diffusely tender and hypersensitive abdomen, with no guarding or peritonism, and no palpable masses. Of note, the patient was very thin, with almost no body fat. Blood tests were otherwise normal, with a normal abdominal X-ray and abdominal ultrasound. She had undergone three previous abdominal ultrasounds over the past 5?years for similar symptoms, all of which were normal. Following this, CT revealed a diagnosis of superior mesenteric artery syndrome. The patient was transferred to our regional children's hospital for analgaesia, nasogastric decompression and nutritional supplementation. She made a swift improvement with plans for ongoing follow-up by the paediatric team. PMID:25721841

  9. Revisiting Russell's Viper (Daboia russelii) Bite in Sri Lanka: Is Abdominal Pain an Early Feature of Systemic Envenoming?

    PubMed Central

    Kularatne, Senanayake A. M.; Silva, Anjana; Weerakoon, Kosala; Maduwage, Kalana; Walathara, Chamara; Paranagama, Ranjith; Mendis, Suresh

    2014-01-01

    The Russell's viper (Daboia russelii) is responsible for 30–40% of all snakebites and the most number of life-threatening bites of any snake in Sri Lanka. The clinical profile of Russell's viper bite includes local swelling, coagulopathy, renal dysfunction and neuromuscular paralysis, based on which the syndromic diagnostic tools have been developed. The currently available Indian polyvalent antivenom is not very effective in treating Russell's viper bite patients in Sri Lanka and the decision regarding antivenom therapy is primarily driven by clinical and laboratory evidence of envenoming. The non-availability of early predictors of Russell's viper systemic envenoming is responsible for considerable delay in commencing antivenom. The objective of this study is to evaluate abdominal pain as an early feature of systemic envenoming following Russell's viper bites. We evaluated the clinical profile of Russell's viper bite patients admitted to a tertiary care centre in Sri Lanka. Fifty-five patients were proven Russell's viper bite victims who produced the biting snake, while one hundred and fifty-four were suspected to have been bitten by the same snake species. Coagulopathy (159, 76.1%), renal dysfunction (39, 18.7%), neuromuscular paralysis (146, 69.9%) and local envenoming (192, 91.9%) were seen in the victims, ranging from mono-systemic involvement to various combinations. Abdominal pain was present in 79.5% of these patients, appearing 5 minutes to 4 hours after the bite. The severity of the abdominal pain, assessed using a scoring system, correlated well with the severity of the coagulopathy (p<0.001) and the neurotoxicity (p<0.001). Its diagnostic validity to predict systemic envenoming is – Sensitivity 81.6%, Specificity 82.4%, Positive predictive value 91.2%. Thus, abdominal pain is an early clinical feature of systemic Russell's viper bite envenoming in Sri Lanka. However, it is best to judge abdominal pain together with other clinical manifestations on decision making. PMID:24587278

  10. The effects of abdominal draw-in maneuver and core exercise on abdominal muscle thickness and Oswestry disability index in subjects with chronic low back pain

    PubMed Central

    Park, Seong-Doo; Yu, Seong-Hun

    2013-01-01

    The purpose of this study was to effects of abdominal draw-in maneuver and core exercise with 4 weeks using the musculoskeletal ultrasonography on muscle thickness and disability in subjects with low back pain. Twenty patients with nonspecific back pain (abdominal draw-in maneuver group: n= 10, core exercise group: n= 10) were recruited in the study. Both group received exercise intervention 3 times a week for 4weeks. The test were based on muscle thickness (transversus abdominis; Tra, internal oblique; IO and external oblique; EO), disability (Oswestry disability index; ODI) measured immediately before and after intervention. The data was measured by SPSS program 12.0 version and analyzed by Paired t-test and Independent t-test. The following results were obtained. The thickness of IO, EO for both group significantly improved except for muscle thickness of Tra. The ODI were significant difference for both groups. As the results of this study, we suggest that it may be effective method to apply to increase for the thickness of Tra, EO using abdominal draw-in maneuver and thickness of IO using core exercise. PMID:24278873

  11. The Treatment of Recurrent Abdominal Pain in Children: A Controlled Comparison of Cognitive-Behavioral Family Intervention and Standard Pediatric Care.

    ERIC Educational Resources Information Center

    Sanders, Matthew R.; And Others

    1994-01-01

    Conducted controlled clinical trial involving 44 children with recurrent abdominal pain randomly assigned to cognitive-behavioral family intervention (CBFI) or standard pediatric care (SPC). Both treatments resulted in significant improvements on measures of pain intensity and pain behavior. CBFI group had higher rate of complete elimination of…

  12. Pseudo-Crohn's disease with bloody diarrhea

    Microsoft Academic Search

    Hilary Klein; G. Aaron du Vall; Samuel Klein

    1995-01-01

    Munchausen's syndrome is a psychiatric disorder in which patients fabricate an array of symptoms and signs of serious medical illness in repeated attempts to gain hospital admission where they undergo diagnostic procedures, medical treatment, and surgeries. We report a patient with Munchausen's syndrome who presented with bloody diarrhea and factitious Crohn's disease. The dramatic clinical presentation delayed diagnosis. Negative feelings

  13. [Retroperitoneal liposarcoma as etiology of abdominal pain. Case report and literature review].

    PubMed

    Pérez-Ponce, Yisvanth; Castellanos-Alejandre, Raúl; Guerrero-Romero, J Francisco; Estrada-León, Felipe; Torres-Lobatón, Alfonso

    2008-01-01

    Soft tissue sarcomas are very uncommon types of tumors, with their embryological origin in the mesoderm and in nerve structures of the neuroectodermic layer. They represent only 1.5% of cases in the National Registry of Malignant Tumors in Mexico. They can be encountered anywhere connective soft tissue is found. Because of their specialized localization, retroperitoneal soft tissue sarcomas have a propensity to remain asymptomatic for long periods of time and reach a large size before being diagnosed. The only accepted treatment is wide surgical excision with clear margins, without a clear benefit for adjuvant treatment. The very uncommon nature of these tumors and their varied histopathology, site and behavior classify them as a difficult entity in terms of treatment. We present here the case of a 66-year-old female with a left-side retroperitoneal tumor, complaining only of vague abdominal pain as the presenting symptom. A CT-guided needle biopsy reported a sarcoma and the patient was subjected to laparatomy with complete resection of the tumor (30 x 13 x 10 cm). Histopathological report demonstrated a low-grade retroperitoneal sarcoma and free macroscopic and microscopic borders, without obvious invasion except for left kidney and ureter. The patient refused adjuvant treatment, and she is disease-free 7 years after treatment. Retroperitoneal sarcomas can cause pain and reach very large sizes. The best treatment available is wide surgical resection with clear margins. The most important prognostic factors are free margins, type of resection, age of patient and tumor histology. PMID:18492425

  14. Sex and disease-related alterations of anterior insula functional connectivity in chronic abdominal pain.

    PubMed

    Hong, Jui-Yang; Kilpatrick, Lisa A; Labus, Jennifer S; Gupta, Arpana; Katibian, David; Ashe-McNalley, Cody; Stains, Jean; Heendeniya, Nuwanthi; Smith, Suzanne R; Tillisch, Kirsten; Naliboff, Bruce; Mayer, Emeran A

    2014-10-22

    Resting-state functional magnetic resonance imaging has been used to investigate intrinsic brain connectivity in healthy subjects and patients with chronic pain. Sex-related differences in the frequency power distribution within the human insula (INS), a brain region involved in the integration of interoceptive, affective, and cognitive influences, have been reported. Here we aimed to test sex and disease-related alterations in the intrinsic functional connectivity of the dorsal anterior INS. The anterior INS is engaged during goal-directed tasks and modulates the default mode and executive control networks. By comparing functional connectivity of the dorsal anterior INS in age-matched female and male healthy subjects and patients with irritable bowel syndrome (IBS), a common chronic abdominal pain condition, we show evidence for sex and disease-related alterations in the functional connectivity of this region: (1) male patients compared with female patients had increased positive connectivity of the dorsal anterior INS bilaterally with the medial prefrontal cortex (PFC) and dorsal posterior INS; (2) female patients compared with male patients had greater negative connectivity of the left dorsal anterior INS with the left precuneus; (3) disease-related differences in the connectivity between the bilateral dorsal anterior INS and the dorsal medial PFC were observed in female subjects; and (4) clinical characteristics were significantly correlated to the insular connectivity with the dorsal medial PFC in male IBS subjects and with the precuneus in female IBS subjects. These findings are consistent with the INS playing an important role in modulating the intrinsic functional connectivity of major networks in the resting brain and show that this role is influenced by sex and diagnosis. PMID:25339739

  15. Chronic Abdominal Pain Secondary to Mesh Erosion Into Ceacum Following Incisional Hernia Repair: A Case Report and Literature Review

    PubMed Central

    Aziz, Fahad; Zaeem, Misbah

    2014-01-01

    Incisional hernias following abdominal operations are a common complication. Mesh is frequently employed in repair of these hernias. Mesh migration is an infrequent occurrence. We present the case of transmural mesh migration from the abdominal wall into the ceacum presenting as chronic abdominal pain. Given the popularity of minimally invasive surgery utilizing polypropylene mesh for incisional hernia repair, related complications such as postoperative hematoma and seroma, foreign body reaction, organ injury, infection, mesh rejection and fistula are increasingly being noted. Most of the mesh migrations reported in the literature involve the urinary bladder. We present a case of delayed mesh migration into the ceacum. Mesh migration is a rare and peculiar complication that is rarely reported in the literature. A review of the literature shows that there are no other cases of mesh migration into ceacum several years after open type incisional hernia repair. PMID:24578759

  16. Quality of life and health care consultation in 13 to 18 year olds with abdominal pain predominant functional gastrointestinal diseases

    PubMed Central

    2014-01-01

    Background Abdominal pain predominant functional gastrointestinal diseases (AP-FGD) are commonly seen in the paediatric age group. It has significant impact on daily activities of affected children. Main objective of this study was to assess the health related quality of life (HRQoL) in children with AP-FGD. Method This was a cross sectional survey conducted in children aged 13–18 years, in four randomly selected schools in Western province of Sri Lanka. Data was collected using a previously validated, self-administered questionnaire. It had questions on symptoms, HRQoL and health care consultation. AP-FGD were diagnosed using Rome III criteria. Results A total of 1850 questionnaires were included in the analysis [males 1000 (54.1%), mean age 14.4 years and SD 1.3 years]. Of them, 305 (16.5%) had AP-FGD [irritable bowel syndrome?=?91(4.9%), functional dyspepsia?=?11 (0.6%), abdominal migraine?=?37 (1.9%) and functional abdominal pain?=?180 (9.7%)]. Lower HRQoL scores for physical (83.6 vs. 91.4 in controls), social (85.0 vs. 92.7), emotional (73.6 vs. 82.7) and school (75.0 vs. 82.5) functioning domains, and lower overall scores (79.6 vs. 88.0) were seen in children with AP-FGD (p?abdominal pain (r?=??0.24, p?abdominal bloating and vomiting (p?

  17. Frequent Abdominal Pain in Childhood and Youth: A Systematic Review of Psychophysiological Characteristics

    PubMed Central

    Müller, Judith; Schwille-Kiuntke, Juliane; Schlarb, Angelika Anita

    2014-01-01

    Background. Frequent abdominal pain (AP) in children and adolescents is often designated as functional gastrointestinal disorder. In contrast to research on psychological and social influences on the experience of AP in this population, psychophysiological features such as function of the autonomic nervous system, the central nervous system, or the endocrine system have rarely been studied. Methods. We conducted a systematic literature search for peer-reviewed journal articles referring to children with AP between 4 and 18 years. Studies on experimental baseline characteristics or reactivity of psychophysiological outcome parameters (autonomous nervous system, central nervous system, and endocrine parameters) were included. Key Results. Twelve of 18 included studies found psychophysiological differences between children with AP and healthy ones. These studies indicate a possible autonomic dysregulation and hypersensitivity of the central nervous system in children with AP following stimulation with stress or other intense stimuli. Mainly conflicting results were found regarding baseline comparisons of autonomic and endocrine parameters. Conclusions and Inferences. Frequent AP in children may be associated with an altered psychophysiological reaction on intense stimuli. It has to be considered that the current literature on psychophysiological characteristics of childhood AP is small and heterogeneous. In particular, multiparameter studies using validated experimental paradigms are lacking. PMID:24744777

  18. Restoration of vagal tone: a possible mechanism for functional abdominal pain.

    PubMed

    Sowder, Erik; Gevirtz, Richard; Shapiro, Warren; Ebert, Crystal

    2010-09-01

    Functional abdominal pain (FAP) causes disruption of daily activities/missed school days, over utilization of healthcare, unnecessary surgeries, and anxiety in 10-15% of children. Its etiology is not clearly understood, however the success of several clinical protocols suggests that autonomic dysregulation is a factor. In this study autonomic activity, including heart rate variability (HRV), was compared between children with FAP and a comparison group. Twenty children with FAP and 10 children without FAP between the ages of 5 and 17 years old were compared on autonomic regulation using an ambulatory system at baseline and 8 weeks later. Children with FAP participated in 6 sessions of HRV biofeedback aimed at normalizing autonomic balance. At baseline, children with FAP appear to have more autonomic dysregulation than children without FAP. After completing HRV biofeedback, the FAP group was able to significantly reduce their symptoms in relation to significantly increasing their autonomic balance. In a sample of children with FAP, it appears that HRV biofeedback treatment improved their symptoms and that a change in vagal tone was a potential mediator for this improvement. The present study appears to point to excessive vagal withdrawal as an underlying mechanism of FAP. PMID:20229150

  19. Normal intestinal rotation with non-fixation: a cause of chronic abdominal pain.

    PubMed

    Janik, J S; Ein, S H

    1979-12-01

    The majority of clinically significant gastrointestinal rotational anomalies involve:(1) an arrest of rotation about the superior mesenteric vessels, (2) abnormal peritoneal bands, and (3) obstruction with or without volvulus. Between 1973 and 1978, six children had chronic intermittent volvulus secondary to a nonfixed but normally-rotated intestine; this is 10% of all infants and children treated for malrotation in our hospital during the same period. Barium studies showed normal duodenojejunal configuration and a colon that was normally situated on at least one study. All were labeled as functional complainers by their pediatricians. One died of a volvulus because her complaints were appreciated too late. At laparotomy, evidence of chronic intermittent volulus secondary to nonfixation from the ligament of Treitz to the transverse colon was found in all patients. A Ladd procedure with appendectomy was performed and immediate resolution of symptoms was noted in each surviving child. Children with a story of chronic abdominal pain deserve a carefully interpreted history and radiographic examination before being labeled as chronic complainers. PMID:551142

  20. Cases in Space Medicine: Right Lower Quadrant Abdominal Pain in a Female Crewmember on the International Space Station

    NASA Technical Reports Server (NTRS)

    Hamilton, Douglas R.; Scheuring, Richard; Jones, Jeffery

    2007-01-01

    A case study of a medical emergency aboard the International Space Station is reviewed. The case involves a female crewmember who is experiencing acute abdominal pain. The interplay of the Crew Medical Officer (CMO) and the NASA Flight Surgeon is given. Possible diagnoses, and advised medical actions are reviewed. Along the case study questions are posed to the reader, and at the end answers are given.

  1. Changes in muscle strength and pain in response to surgical repair of posterior abdominal wall disruption followed by rehabilitation

    PubMed Central

    Hemingway, A; Herrington, L; Blower, A

    2003-01-01

    Background: Posterior abdominal wall deficiency (PAWD) is a tear in the external oblique aponeurosis or the conjoint tendon causing a posterior wall defect at the medial end of the inguinal canal. It is often known as sportsman's hernia and is believed to be caused by repetitive stress. Objective: To assess lower limb and abdominal muscle strength of patients with PAWD before intervention compared with matched controls; to evaluate any changes following surgical repair and rehabilitation. Methods: Sixteen subjects were assessed using a questionnaire, isokinetic testing of the lower limb strength, and pressure biofeedback testing of the abdominals. After surgery and a six week rehabilitation programme, the subjects were re-evaluated. A control group were assessed using the same procedure. Results: Quadriceps and hamstrings strength was not affected by this condition. A deficit hip muscle strength was found on the affected limb before surgery, which was significant for the hip flexors (p = 0.05). Before surgery, 87% of the patients compared with 20% of the controls failed the abdominal obliques test. Both the injured and non-injured sides had improved significantly in strength after surgery and rehabilitation. The strength of the abdominal obliques showed the most significant improvement over the course of the rehabilitation programme. Conclusions: Lower limb muscle strength may have been reduced as the result of disuse atrophy or pain inhibition. Abdominal oblique strength was deficient in the injured patients and this compromises rotational control of the pelvis. More sensitive investigations (such as electromyography) are needed to assess the link between abdominal oblique function and groin injury. PMID:12547744

  2. Spontaneous splenic rupture and Anisakis appendicitis presenting as abdominal pain: a case report

    PubMed Central

    2012-01-01

    Introduction Anisakidosis, human infection with nematodes of the family Anisakidae, is caused most commonly by Anisakis simplex. Acquired by the consumption of raw or undercooked marine fish or squid, anisakidosis occurs where such dietary customs are practiced, including Japan, the coastal regions of Europe and the United States. Rupture of the spleen is a relatively common complication of trauma and many systemic disorders affecting the reticuloendothelial system, including infections and neoplasias. A rare subtype of rupture occurring spontaneously and arising from a normal spleen has been recognized as a distinct clinicopathologic entity. Herein we discuss the case of a woman who presented to our institution with appendicitis secondary to Anisakis and spontaneous spleen rupture. Case presentation We report the case of a 53-year-old Caucasian woman who presented with hemorrhagic shock and abdominal pain and was subsequently found to have spontaneous spleen rupture and appendicitis secondary to Anisakis simplex. She underwent open surgical resection of the splenic rupture and the appendicitis without any significant postoperative complications. Histopathologic examination revealed appendicitis secondary to Anisakis simplex and splenic rupture of undetermined etiology. Conclusions To the best of our knowledge, this report is the first of a woman with the diagnosis of spontaneous spleen rupture and appendicitis secondary to Anisakis simplex. Digestive anisakiasis may present as an acute abdomen. Emergency physicians should know and consider this diagnosis in patients with ileitis or colitis, especially if an antecedent of raw or undercooked fish ingestion is present. Spontaneous rupture of the spleen is an extremely rare event. Increased awareness of this condition will enhance early diagnosis and effective treatment. Further research is required to identify the possible risk factors associated with spontaneous rupture of the spleen. PMID:22524971

  3. High prevalence of abdominal aortic aneurysm in patients with chronic low back pain.

    PubMed

    Tsuchie, Hiroyuki; Miyakoshi, Naohisa; Kasukawa, Yuji; Nishi, Tomio; Abe, Hidekazu; Takeshima, Masaaki; Shimada, Yoichi

    2013-01-01

    Low back pain (LBP) is one of the most common symptoms in outpatient clinics, and abdominal aortic aneurysm (AAA) is one of the causes of LBP. In the present study, we examined the prevalence of chronic LBP in patients with aortic aneurysm. The study included 23 patients with AAA and 23 patients with thoracic aortic aneurysm (TAA); all of them visited a regional center hospital in Akita, Japan. A total of 207 hypertension patients were also enrolled as a control. Chronic LBP was defined in patients who visited the orthopedic outpatient clinic for the LBP treatment for more than three months. The prevalence of chronic LBP in the AAA group (52.2%) was significantly higher than that in the TAA (17.4%, P < 0.05) or hypertension patients (11.6%, P < 0.01). The rate of a trigger point (TP) injection was significantly higher in the AAA group or the TAA group than that in hypertension patients (P < 0.01, P < 0.05), but there was no significant difference between the AAA and TAA groups. The TP injection represents an injection of local anesthesia to the low back muscles. We also evaluated the involvement of various factors in LBP caused by AAA, such as age, gender, blood pressure, the existence of dissection, and the maximum diameter of AAA, but none of them showed significant relationship to LBP. The prevalence of LBP is high in AAA patients, and doctors who treat chronic LBP should be aware of AAA as a potential cause of LBP. PMID:23759898

  4. Incidental detection of ascariasis worms on USG in a protein energy malnourished (PEM) child with abdominal pain.

    PubMed

    Suthar, Pokhraj Prakashchandra; Doshi, Rajkumar Prakashbhai; Mehta, Chetan; Vadera, Khyati P

    2015-01-01

    A 10-year-old child presented with dull aching periumbilical abdominal pain for 15?days. The child was not gaining weight despite a good appetite. Physical examination of the child revealed grade-I protein energy malnourishment (PEM) according to IAP (Indian Academic of Paediatrics) classification. The rest of the systemic examination was normal. Routine blood investigation revealed anaemia with eosinophilia. Abdominal ultrasonography did not show any abnormality with curvilinear transducer (3.5-5?MHz), however, linear ultrasound transducer (7.5-12?MHz) with harmonic tissue imaging showed worms in the lumen of the small intestine with curling movement on real time scanning. Stool examination for the eggs of ascariasis was positive. The patient was treated with antihelminthic drugs. Dietary modification for the PEM was advised. After 3?months of treatment, the patient improved and stool examination for Ascaris was negative on follow-up. PMID:25766437

  5. Groin pain

    MedlinePLUS

    Pain - groin; Lower abdominal pain; Genital pain; Perineal pain ... The health care provider will do an exam of the groin area and ask questions about your medical history and symptoms, such as: Have you had an injury recently? Has there ...

  6. Acute Renal Infarction Presenting with Acute Abdominal Pain Secondary to Newly Discovered Atrial Fibrillation: A Case Report and Literature Review

    PubMed Central

    Eltawansy, Sherif Ali; Patel, Shil; Hassanien, Samaa; Maniar, Mihir

    2014-01-01

    We report an 85-year-old female with known history of recurrent diverticulitis presented with abdominal pain. It was believed that the patient again needed to be treated for another diverticulitis and was started on the routine treatment. The initial CT scan of abdomen showed renal infarcts bilaterally that were confirmed by a CT with and without intravenous contrast secondary to unknown cause. An ECG found accidentally that the patient was in atrial fibrillation, which was the attributed factor to the renal infarctions. Subsequently, the patient was started on the appropriate anticoagulation and discharged. PMID:25614841

  7. Lassoing of the small bowel mesentery and abdominal pain caused by band tubing after "band on bypass".

    PubMed

    Magee, Conor; Saha, Shopon; Kerrigan, David D

    2013-01-01

    Weight regain after laparoscopic gastric bypass can be difficult to manage. A common finding is an enlarged gastrojejunal complex (dilated gastric pouch and/or jejunum, dilated gastrojejunal anastomosis). Revision of the gastrojejunal complex can be accomplished by surgical resection, endoscopic plication techniques, or more recently, placement of an adjustable band around the dilated gastric pouch ("band on bypass," BoB). We present an unusual complication of the BoB procedure, in which the band tubing looped around the small bowel causing severe abdominal pain. PMID:23219587

  8. Pathology Case Study: Bloody Vaginal Discharge

    NSDL National Science Digital Library

    Dickson, H.

    This is a case study presented by the University of Pittsburgh Department of Pathology in which an elderly woman experienced bloody vaginal discharge long after menopause. Visitors are given both the microscopic pap smear and biopsy findings, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in gynecologic pathology.

  9. High prevalence of chronic pelvic pain in women in Ribeirão Preto, Brazil and direct association with abdominal surgery

    PubMed Central

    de Oliveira Gonçalves da Silva, Gabriela Pagano; do Nascimento, Anderson Luís; Michelazzo, Daniela; Junior, Fernando Filardi Alves; Rocha, Marcelo Gondim; Rosa-e-Silva, Júlio César; Candido-dos-Reis, Francisco José; Nogueira, Antonio Alberto; Poli-Neto, Omero Benedicto

    2011-01-01

    INTRODUCTION: Chronic pelvic pain is a disease that directly affects the social and professional lives of women. OBJECTIVE: To estimate the prevalence of this clinical condition and to identify independent factors associated with it in women living in Ribeirão Preto, Brazil. METHODS: A one-year cross-sectional study was conducted in a population sample of 1,278 women over the age of 14 years. The target population was predominantly composed of women who are treated by the public health system. The questionnaire was administered by interviewers who were not linked to the city health care programs. The prevalence of the morbidity was estimated. First, we identified the significant variables associated with pelvic pain (p<0.10) and then we attributed values of 0 or 1 to the absence or presence of these variables. Logistic regression analysis was used to identify and estimate the simultaneous impact of the independent variables. The results were expressed by odds ratio and their 95% confidence interval with p<0.05. RESULTS: The disease was found in 11.5% (147/1,278) of the sample. The independent predictors were dyspareunia, previous abdominal surgery, depression, dysmenorrhea, anxiety, current sexual activity, low back pain, constipation, urinary symptoms, and low educational level. CONCLUSION: The prevalence of chronic pelvic pain in Ribeirão Preto is high and is associated with conditions that can usually be prevented, controlled, or resolved by improvement of public health policies and public education. PMID:21915476

  10. Splenorenal Collaterals as Hallmark for a Twisted Wandering Spleen in a 14-Year-Old Girl with Abdominal Pain: A Case Report

    PubMed Central

    Rellum, Rashidi; Risseeuw, Gerard; Blaauw, Ivo de; Lequin, Maarten

    2014-01-01

    Wandering spleen is a rare cause of acute or chronic recurrent abdominal pain with a risk of splenic torsion and infarction. We describe a case of a 14-year-old girl with chronic recurrent abdominal pain with a palpable spleen in normal position on the initial physical examination. Laboratory findings were normal. A normal blood flow was seen on the initial (color Doppler) sonography. Magnetic resonance imaging showed an enlarged spleen in the pelvic region with torsion of hilar pedicle and splenorenal collaterals. Semielective, a laparoscopic splenopexy was performed without complications. A twisted wandering spleen should be included in the differential diagnosis of recurrent abdominal pain despite possible normal positioning of the spleen. The presence of splenorenal collaterals on imaging techniques can be used as a diagnostic hallmark. PMID:25755964

  11. Intranasal Sufentanil for Postoperative Pain Control in Lower Abdominal Pediatric Surgery

    Microsoft Academic Search

    FARHAD HESHMATI; HEIDAR NOROOZINIA; RAHMAN ABBASIVASH; ALIREZA MAHOORI; HELEN GHARAEE

    The most important role in postoperative pain management is still played by opioid administration through various modes. For the last few years, there has been an intensive search for alternative mode of opioid administration in pain management. The intranasal modes of opioid administration seems to be an attrac- tive alternative. Sixty boys (aged 0.5-6 yr); ASA (American Society of Anesthesiologists)

  12. Subtypes of irritable bowel syndrome based on abdominal pain/discomfort severity and bowel pattern

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Irritable bowel syndrome (IBS) has traditionally been classified by stooling pattern (e.g., diarrhea-predominant). However, other patterns of symptoms have long been recognized, e.g., pain severity. Our objective was to examine the utility of subtyping women with IBS based on pain/discomfort severit...

  13. Prospective comparison of helical CT of the abdomen and pelvis without and with oral contrast in assessing acute abdominal pain in adult Emergency Department patients

    Microsoft Academic Search

    Steve Y. Lee; Bret Coughlin; Jeannette M. Wolfe; Joseph Polino; Fidela S. Blank; Howard A. Smithline

    2006-01-01

    Purpose  This prospective study compares the agreement of nonenhanced helical computed tomography (NECT) with oral contrast-enhanced\\u000a computed tomography (CECT) in Emergency Department (ED) patients presenting with acute abdominal pain.\\u000a \\u000a \\u000a \\u000a Materials and methods  One hundred eighteen patients presenting to the ED with acute abdominal pain undergoing CT were enrolled over a 13-month period\\u000a using convenience sampling. Exclusion criteria included acute trauma, pregnancy, unstable

  14. Autonomic nervous system function in young children with functional abdominal pain or irritable bowel syndrome

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Adults with irritable bowel syndrome (IBS) have been reported to have alterations in autonomic nervous system function as measured by vagal activity via heart rate variability. Whether the same is true for children is unknown. We compared young children 7 to 10 years of age with functional abdominal...

  15. Dying Speeches & Bloody Murders: Crime Broadsides

    NSDL National Science Digital Library

    "Dying speeches & Bloody Murders" might not sound like a site to visit right before bedtime, but this engaging and fascinating collection brings together an important set of crime broadsides that will engage the attention of historians, legal scholars, and anyone with an interest in the history of crime and punishment. This collection comes from the Harvard Law School Library, and the conservation and digitization of these broadsides was made possible by a generous grant from the Peck Stacpoole Foundation. These broadsides would have been sold in much the same way a program would be sold today at a major sporting event. Their price was usually quite low, and they usually featured a description of the crime in question and a variety of illustrations. Here visitors can view over 500 of these broadsides, and they can browse around at their leisure, or search by category or keyword.

  16. Blood glucose self-monitoring from abdominal skin: a precise and virtually pain-free method

    Microsoft Academic Search

    A. Holstein; E. Thiessen; N. Kaufmann; A. Plaschke; E. H. Egberts

    2002-01-01

    For many diabetic patients, years of blood glucose self-monitoring (SM) with readings taken several times daily is an inevitable\\u000a aspect of insulin therapy. We investigated whether SM from abdominal skin might be an alternative to the established fingertip\\u000a method. A total of 63 diabetic patients and 16 nondiabetic volunteers determined their blood glucose in parallel in capillary\\u000a blood from the

  17. Delayed Bleeding and Pelvic Haematoma after Low-Energy Osteoporotic Pubic Rami Fracture in a Warfarin Patient: An Unusual Cause of Abdominal Pain

    PubMed Central

    Sandri, Andrea

    2014-01-01

    Introduction. Acute abdominal pain may be the presenting symptom in a wide range of diseases in the elderly. Acute abdominal pain related to a delayed bleeding and pelvic haematoma after a low-energy pubic rami fracture is rare and can have important consequences; to the best of our knowledge, only one case has been previously described. Case Report. We present an unusual case of an 83-year-old woman taking warfarin for atrial fibrillation, admitted to the Emergency Department (ED) with acute abdominal pain and progressive anemia related to a delayed bleeding and pelvic haematoma 72 hours after a low-energy osteoporotic pubic rami fracture. Warfarin was withheld, anticoagulation was reversed by using fresh frozen plasma and vitamin K, and concentrated red blood cells were given. Haemoglobin level gradually returned to normal with a progressive resorption of the haematoma. Conclusion. Delayed bleeding and pelvic haematoma after osteoporotic pubic rami fracture should be considered in the differential diagnosis of acute abdominal pain in the elderly. This case indicates the need for hospital admission, careful haemodynamic monitoring, and early identification of bleeding in patients with “benign” osteoporotic pubic rami fracture, especially those receiving anticoagulants, to provide an adequate management and prevent severe complications. PMID:25143839

  18. Young children with functional abdominal pain (FAP) and irritable bowel syndrome (IBS) followed in pediatric gastroenterology (PED-GI) vs primary pediatric care (PED): Differences in outcomes

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The American Academy of Pediatrics suggests that children with recurrent abdominal pain without alarm signs be managed in pediatric rather than specialty care. However, many of these children are seen in tertiary care. In a longitudinal examination of physical and psychological symptoms, we hypothes...

  19. Belly Pain

    MedlinePLUS

    ... tract infection or a blocked intestine. Infection by bacteria or a parasite, heartburn , irritable bowel disease , or ... to have abdominal pain, the pain in your gut may really be a pain in your brain. ...

  20. Altered response of the anterolateral abdominal muscles to simulated weight-bearing in subjects with low back pain

    PubMed Central

    Belavý, Daniel L.; Cassar, Lana; Williams, Michelle; Wilson, Stephen J.; Richardson, Carolyn A.

    2008-01-01

    An important aspect of neuromuscular control at the lumbo-pelvic region is stabilization. Subjects with low back pain (LBP) have been shown to exhibit impairments in motor control of key muscles which contribute to stabilization of the lumbo-pelvic region. However, a test of automatic recruitment that relates to function has been lacking. A previous study used ultrasound imaging to show that healthy subjects automatically recruited the transversus abdominis (TrA) and internal oblique (IO) muscles in response to a simulated weight-bearing task. This task has not been investigated in subjects with LBP. The aim of this study was to compare the automatic recruitment of the abdominal muscles among subjects with and without LBP in response to the simulated weight-bearing task. Twenty subjects with and without LBP were tested. Real-time ultrasound imaging was used to assess changes in thickness of the TrA and internal oblique IO muscles as well as lateral movement (“slide”) of the anterior fascial insertion of the TrA muscle. Results showed that subjects with LBP showed significantly less shortening of the TrA muscle (P < 0.0001) and greater increases in thickness of the IO muscle (P = 0.002) with the simulated weight-bearing task. There was no significant difference between groups for changes in TrA muscle thickness (P = 0.055). This study provides evidence of changes in motor control of the abdominal muscles in subjects with LBP. This test may provide a functionally relevant and non-invasive method to investigate the automatic recruitment of the abdominal muscles in people with and without LBP. PMID:19015895

  1. Associations between low back pain, urinary incontinence, and abdominal muscle recruitment as assessed via ultrasonography in the elderly

    PubMed Central

    Figueiredo, Vânia F.; Amorim, Juleimar S. C.; Pereira, Aline M.; Ferreira, Paulo H.; Pereira, Leani S. M.

    2015-01-01

    Background: Low back pain (LBP) and urinary incontinence (UI) are highly prevalent among elderly individuals. In young adults, changes in trunk muscle recruitment, as assessed via ultrasound imaging, may be associated with lumbar spine stability. Objective: To assess the associations between LBP, UI, and the pattern of transversus abdominis (TrA), internal (IO), and external oblique (EO) muscle recruitment in the elderly as evaluated by ultrasound imaging. Method: Fifty-four elderly individuals (mean age: 72±5.2 years) who complained of LBP and/or UI as assessed by the McGill Pain Questionnaire, Incontinence Questionnaire-Short Form, and ultrasound imaging were included in the study. The statistical analysis comprised a multiple linear regression model, and a p-value <0.05 was considered significant. Results: The regression models for the TrA, IO, and EO muscle thickness levels explained 2.0% (R2=0.02; F=0.47; p=0.628), 10.6% (R2=0.106; F=3.03; p=0.057), and 10.1% (R2=0.101; F=2.70; p=0.077) of the variability, respectively. None of the regression models developed for the abdominal muscles exhibited statistical significance. A significant and negative association (p=0.018; ?=-0.0343) was observed only between UI and IO recruitment. Conclusion: These results suggest that age-related factors may have interfered with the findings of the study, thus emphasizing the need to perform ultrasound imaging-based studies to measure abdominal muscle recruitment in the elderly. PMID:25714438

  2. A Randomized Controlled Trial of a Cognitive-Behavioral Family Intervention for Pediatric Recurrent Abdominal Pain

    Microsoft Academic Search

    Paul M. Robins; Suzanne M. Smith; Joseph J. Glutting; Chanelle T. Bishop

    2005-01-01

    Objective To investigate whether the combination of standard medical care (SMC) and short-term cognitive-behavioral family treatment (CBT) in the treatment of recurrent abdom- inal pain (RAP) was more effective than SMC alone. Methods Children recently diagnosed with RAP via physician examination were randomized into SMC (n = 29) and SMC plus CBT (n = 40) groups. Outcome measures included multiple

  3. Abdominal Aortic Aneurysms: Treatments

    MedlinePLUS

    ... renal disease Infertility Liver disease Needle biopsy Osteoporosis Pediatrics Pelvic pain ... Aortic Aneurysms Interventional Radiologists Treat Abdominal Aneurysms Nonsurgically Interventional radiologists ...

  4. Acute abdominal pain during an Antarctic cruise--a case report.

    PubMed

    Dahl, Eilif

    2012-01-01

    A 21-year-old female crew member experienced a number of medical conditions during a summer cruise to the Antarctic Peninsula. At one point symptoms and signs strongly suggested acute appendicitis. She was monitored and treated conservatively on board and recovered uneventfully without surgery. Later she had a biliary colic attack and then an allergic reaction to the pain medication given. The pre-employment medical fitness certificate cannot always be trusted regarding previous history of allergies and medical conditions. PMID:22972550

  5. EPIDEMIOLOGY OF SPORADIC BLOODY DIARRHEA IN RURAL WESTERN KENYA

    Microsoft Academic Search

    JOHN T. BROOKS; ROGER L. SHAPIRO; LATA KUMAR; JOY G. WELLS; PENELOPE A. PHILLIPS-HOWARD; YA-PING SHI; JOHN M. VULULE; ROBERT M. HOEKSTRA; ERIC MINTZ; LAURENCE SLUTSKER

    2003-01-01

    We conductedlaboratory-basedsurveillance anda case-control study to c haracterize the epidemiology of bloody diarrhea in rural Western Kenya. From May 1997 through April 2001, we collectedstool from 451 persons with bloody diarrhea presenting to four rural clinics. Cultures of 231 (51%) specimens yielded 247 bacterial pathogens: 198 Shigella (97 S. flexneri, 41 S. dysenteriae type 1, 39 S. dysenteriae type non-1,

  6. Lemmel's syndrome, an unusual cause of abdominal pain and jaundice by impacted intradiverticular enterolith: case report.

    PubMed

    Kang, Hyo Sung; Hyun, Jong Jin; Kim, Seung Young; Jung, Sung Woo; Koo, Ja Seol; Yim, Hyung Joon; Lee, Sang Woo

    2014-06-01

    Duodenal diverticula are detected in up to 27% of patients undergoing upper gastrointestinal tract evaluation with periampullary diverticula (PAD) being the most common type. Although PAD usually do not cause symptoms, it can serve as a source of obstructive jaundice even when choledocholithiasis or tumor is not present. This duodenal diverticulum obstructive jaundice syndrome is called Lemmel's syndrome. An 81-yr-old woman came to the emergency room with obstructive jaundice and cholangitis. Abdominal CT scan revealed stony opacity on distal CBD with CBD dilatation. ERCP was performed to remove the stone. However, the stone was not located in the CBD but rather inside the PAD. After removal of the enterolith within the PAD, all her symptoms resolved. Recognition of this condition is important since misdiagnosis could lead to mismanagement and therapeutic delay. Lemmel's syndrome should always be included as one of the differential diagnosis of obstructive jaundice when PAD are present. PMID:24932093

  7. Abdominal aortic aneurysm

    MedlinePLUS

    ... main blood vessel that supplies blood to the abdomen, pelvis, and legs. An abdominal aortic aneurysm occurs ... dissection). Symptoms of rupture include: Pain in the abdomen or back. The pain may be severe, sudden, ...

  8. Comparative study between epidural morphine and bupivacaine with epidural clonidine and bupivacaine for postoperative pain relief in abdominal surgeries

    PubMed Central

    Parikh, Tapan J.; Divecha, Vishal; Dalwadi, Divyang

    2015-01-01

    Background: Many adjuvants are used to increase the efficacy of epidural local anesthetics for postoperative analgesia. Aims: The aim was to compare the efficacy of epidural morphine (0.1 mg/kg) and clonidine (2 ?g/kg) with bupivacaine (0.125%) for postoperative analgesia in abdominal surgeries. Settings and Design: Double-blind retrospective randomized study. Methodology: All the patients (n = 60) varying from age group belonging to American Society of Anesthesiologists I–II were randomly allocated to receive epidural analgesia Group A - Morphine (0.1 mg/kg). + Bupivacaine (0.125%) (n = 30), Group B - Clonidine (2 ?/kg) + Bupivacaine (0.125%) (n = 30). We monitored vitals and requirement of inhalational gases intra-operatively, pain by visual analogue score (VAS) and vitals postoperatively. We used rescue analgesics (injection diclofenac 1 mg/kg intravenous) when VAS score > 5. Postoperatively, various parameters were monitored for first 2 h at intervals of 30 min and at 4, 8, 12, 16, and 24 hourly intervals after giving 1st dose. Statistical Analysis Used: Continuous data are analyzed by Student's t-test (paired ‘t’-test for intragroup variations and unpaired ‘t’-test for intergroup variations). Chi-square test was used for categorical data. A P ? 0.05 was considered to be statistically significant. Results: Mean duration of analgesia was 8.35 ± 0.42 h in Group A (morphine) and 7.45 ± 0.44 h in Group B (clonidine). This difference was statistically significant (P < 0.001), indicating a prolongation of analgesia in group morphine. There was no need of rescue analgesia in any subjects. Group A patients were hemodynamically stable and required less inhalation agents intra-operatively compared to group B patients. Conclusions: Epidural morphine plus bupivacaine has a longer duration of analgesia and greater hemodynamic stability as compared to epidural clonidine plus bupivacaine for postoperative analgesia in abdominal surgeries.

  9. Emergency medicine physicians' and pediatricians' use of computed tomography in the evaluation of pediatric patients with abdominal pain without trauma in a community hospital.

    PubMed

    Grim, Paul Francis

    2014-05-01

    There is a paucity of data regarding emergency department (ED) provider type and computed tomography (CT) scan use in the evaluation of pediatric patients with abdominal pain without trauma. The purpose of this retrospective single community hospital study was to determine if there was a difference in CT use between emergency medicine physicians (EMPs) and pediatricians (PEDs) in all patients younger than 18 years with abdominal pain without trauma who presented to the ED during the study period. The study included 165 patients. EMPs saw 83 patients and used CT in 31 compared with PEDs who saw 82 patients and used CT in 12 (P = .002). EMPs used CT significantly more frequently than PEDs in the designated sample. Economic pressures may cause changes in ED provider type in community and rural hospitals and this study shows that ED provider type may affect medical decision making, including CT use. PMID:24391124

  10. Cryptogenia multifocal ulcerous stenosing enteritis: an entity on its own as a cause of abdominal pain, iron deficiency anemia and protein-losing enteropathy.

    PubMed

    Guisado Vasco, P; Fraile Rodríguez, G

    2014-01-01

    We studied a patient with edema secondary to protein losing enteropathy, and recurrent bouts of bloating and abdominal pain secondary to intestinal subocclusion episodes. After the clinical study, the patient was diagnosed of cryptogenic multifocal ulcerous stenosing enteritis (CMUSE), that is a rare disease, probably caused by mutations in the gene PLA2G4A, and characterized by multiple short stenosis of the small bowel with superficial ulcers, which do not exceed the submucosa layer. Inflammatory bowel disease (Chron's disease), intestinal tuberculosis and intestinal ulcers secondary to non-steroidal anti-inflammatory drugs are the main differential diagnosis. To sum up, physicians should included CMUSE in the differential diagnosis of recurrent abdominal pain, iron deficiency anaemia, occult intestinal bleeding, edema and protein losing enteropathy. PMID:24035666

  11. Sclerosing mesenteritis as a rare cause of abdominal pain and intraabdominal mass: a cases report and review of the literature

    PubMed Central

    2008-01-01

    Sclerosing mesenteritis is a rare, benign, and chronic fibrosing inflammation disease with unknown etiology that affects the mesentery of small bowel and colon. The disease has two well-established histological types: the acute or subacute form known as mesenteric panniculitis and the chronic form known as retractile or sclerosing mesenteritis. Because the sclerosing mesenteritis is lack of special clinical manifestation and typical signs, so the patients are very easy to be misdiagnosed. The correct diagnosis of sclerosing mesenteritis depends on pathological examination and exploratory laparotomy. We report a case of sclerosing mesenteritis in a 52-year-old male who presented with chronic abdominal pain and intraabdominal mass. This patient had a long-term and heavy drinking history. He was misdiagnosed as celiac teratoma by CT examination and then underwent an exploratory laparotomy at March 2 2004. A mass, its diameter being about 5 cm, was detected in mesentery of distal ileum. Although a few small intestines tightly adhered on the mass, the involved intestine had no obstruction. The intraoperative biopsy indicated that it was an inflammatory mass. The mass and adhered intestines were removed. He was diagnosed with sclerosing mesenteritis by histopathological examination of paraffin section. After operation, this patient went well and lives without recrudescence at the time we wrote this paper. PMID:18925952

  12. Sclerosing mesenteritis as a rare cause of abdominal pain and intraabdominal mass: a cases report and review of the literature.

    PubMed

    Gu, Guo-Li; Wang, Shi-Lin; Wei, Xue-Ming; Ren, Li; Li, De-Chang; Zou, Fu-Xian

    2008-01-01

    Sclerosing mesenteritis is a rare, benign, and chronic fibrosing inflammation disease with unknown etiology that affects the mesentery of small bowel and colon. The disease has two well-established histological types: the acute or subacute form known as mesenteric panniculitis and the chronic form known as retractile or sclerosing mesenteritis. Because the sclerosing mesenteritis is lack of special clinical manifestation and typical signs, so the patients are very easy to be misdiagnosed. The correct diagnosis of sclerosing mesenteritis depends on pathological examination and exploratory laparotomy. We report a case of sclerosing mesenteritis in a 52-year-old male who presented with chronic abdominal pain and intraabdominal mass. This patient had a long-term and heavy drinking history. He was misdiagnosed as celiac teratoma by CT examination and then underwent an exploratory laparotomy at March 2 2004. A mass, its diameter being about 5 cm, was detected in mesentery of distal ileum. Although a few small intestines tightly adhered on the mass, the involved intestine had no obstruction. The intraoperative biopsy indicated that it was an inflammatory mass. The mass and adhered intestines were removed. He was diagnosed with sclerosing mesenteritis by histopathological examination of paraffin section. After operation, this patient went well and lives without recrudescence at the time we wrote this paper. PMID:18925952

  13. Large twisted ovarian fibroma associated with Meigs’ syndrome, abdominal pain and severe anemia treated by laparoscopic surgery

    PubMed Central

    2014-01-01

    Background The Meigs' syndrome is a rare but well-known syndrome defined as the triad of benign solid ovarian tumor, ascites, and pleural effusion. Meigs' syndrome always requires surgical treatment. However, the optimal approach for its management has not been sufficiently investigated. Case presentation We report a patient with a large twisted ovarian fibroma associated with Meigs’ syndrome, abdominal pain and severe hemolytic anemia that was treated by laparoscopic surgery. This case highlights the difficulties that may be encountered in the management of patients with Meigs’ syndrome, including potential misdiagnosis of the tumor as a malignant ovarian neoplasm that may influence the medical and surgical approach and the adverse impact that Meigs’ syndrome can have on the patient’s condition, especially if it is associated with acute pain and severe anemia. Considering the patient’s serious clinical condition and assuming that she had Meigs' syndrome with a twisted large ovarian mass and possible hemolytic anemia, we first concentrated on effective medical management of our patient and chose the most appropriate surgical treatment after laparoscopic examination. The main aim of our initial approach was preoperative management of the anemia. Blood transfusions and glucocorticoid therapy resulted in stabilization of the hemoglobin level and normalization of the bilirubin levels, which confirmed the appropriateness of this approach. Laparoscopic surgery 4 days after admission enabled definitive diagnosis of the tumor, confirmed torsion and removed the bulky ovarian fibroma, resulting in timely resolution of symptoms, short hospitalization, relatively low morbidity and a rapid return to her social and professional life. Conclusions This case highlights the difficulties that may be encountered in the management of patients with Meigs' syndrome, including potential misdiagnosis of the tumor as a malignant ovarian neoplasm that may influence the medical and surgical approach, and the adverse impact that Meigs' syndrome can have on the patient's condition, especially if it is associated with acute pain and severe anemia. The present case suggests that laparoscopic surgery for potentially large malignant tumors is feasible and safe, but requires an appropriate medical and gynecological oncology expertise. PMID:24962423

  14. Sex-Related Differences of Cortical Thickness in Patients with Chronic Abdominal Pain

    PubMed Central

    Jiang, Zhiguo; Dinov, Ivo D.; Labus, Jennifer; Shi, Yonggang; Zamanyan, Alen; Gupta, Arpana; Ashe-McNalley, Cody; Hong, Jui-Yang; Tillisch, Kirsten; Toga, Arthur W.; Mayer, Emeran A.

    2013-01-01

    Background & Aims Regional reductions in gray matter (GM) have been reported in several chronic somatic and visceral pain conditions, including irritable bowel syndrome (IBS) and chronic pancreatitis. Reported GM reductions include insular and anterior cingulate cortices, even though subregions are generally not specified. The majority of published studies suffer from limited sample size, heterogeneity of populations, and lack of analyses for sex differences. We aimed to characterize regional changes in cortical thickness (CT) in a large number of well phenotyped IBS patients, taking into account the role of sex related differences. Methods Cortical GM thickness was determined in 266 subjects (90 IBS [70 predominantly premenopausal female] and 176 healthy controls (HC) [155 predominantly premenopausal female]) using the Laboratory of Neuro Imaging (LONI) Pipeline. A combined region of interest (ROI) and whole brain approach was used to detect any sub-regional and vertex-level differences after removing effects of age and total GM volume. Correlation analyses were performed on behavioral data. Results While IBS as a group did not show significant differences in CT compared to HCs, sex related differences were observed both within the IBS and the HC groups. When female IBS patients were compared to female HCs, whole brain analysis showed significant CT increase in somatosensory and primary motor cortex, as well as CT decrease in bilateral subgenual anterior cingulate cortex (sgACC). The ROI analysis showed significant regional CT decrease in bilateral subregions of insular cortex, while CT decrease in cingulate was limited to left sgACC, accounting for the effect of age and GM volume. Several measures of IBS symptom severity showed significant correlation with CT changes in female IBS patients. Conclusions Significant, sex related differences in CT are present in both HCs and in IBS patients. The biphasic neuroplastic changes in female IBS patients are related to symptom severity. PMID:24040118

  15. Painful swallowing

    MedlinePLUS

    ... ulcers Something stuck in the throat (for example, fish or chicken bones) Tooth infection or abscess ... with the painful swallowing, including: Abdominal pain Chills Cough Fever Heartburn Nausea or vomiting Sour taste in ...

  16. Unexplained abdominal pain as a driver for inappropriate therapeutics: an audit on the use of intravenous proton pump inhibitors

    PubMed Central

    Wong, Yin Yen; Low, Yong Chia; Lau, Hui Ling; Chin, Kin-Fah; Mahadeva, Sanjiv

    2014-01-01

    Background. Proton pump inhibitors (PPIs) are currently the most effective agents for acid-related disorders. However, studies show that 25–75% of patients receiving intravenous PPIs had no appropriate justification, indicating high rates of inappropriate prescribing. Objective. To examine the appropriate use of intravenous PPIs in accordance with guidelines and the efficacy of a prescribing awareness intervention at an Asian teaching institution. Setting. Prospective audit in a tertiary hospital in Malaysia. Method. Every 4th intravenous PPI prescription received in the pharmacy was screened against hospital guidelines. Interventions for incorrect indication/dose/duration were performed. Patients’ demographic data, medical history and the use of intravenous PPI were collected. Included were all adult inpatients prescribed intravenous PPI. Main Outcome Measure. Proportion of appropriate IV PPI prescriptions. Results. Data for 106 patients were collected. Most patients were male [65(61.3%)], Chinese [50(47.2%)], with mean age ± SD = 60.3 ± 18.0 years. Most intravenous PPI prescriptions were initiated by junior doctors from the surgical [47(44.3%)] and medical [42(39.6%)] departments. Only 50/106(47.2%) patients had upper gastrointestinal endoscopy/surgery performed to verify the source of bleeding. Unexplained abdominal pain [81(76.4%)] was the main driver for prescribing intravenous PPIs empirically, out of which 73(68.9%) were for suspected upper gastrointestinal bleed. Overall, intravenous PPI was found to be inappropriately prescribed in 56(52.8%) patients for indication, dose or duration. Interventions on the use of intravenous PPI were most effective when performed by senior doctors (100%), followed by clinical pharmacists (50%), and inpatient pharmacists (37.5%, p = 0.027). Conclusion. Inappropriate intravenous PPI usage is still prevalent despite the enforcement of hospital guidelines. The promotion of prescribing awareness and evidence-based prescribing through education of medical staff could result in more judicious use of intravenous PPI and dose-optimization. PMID:25024919

  17. Pepper Mild Mottle Virus, a Plant Virus Associated with Specific Immune Responses, Fever, Abdominal Pains, and Pruritus in Humans

    PubMed Central

    Colson, Philippe; Richet, Hervé; Desnues, Christelle; Balique, Fanny; Moal, Valérie; Grob, Jean-Jacques; Berbis, Philippe; Lecoq, Hervé; Harlé, Jean-Robert; Berland, Yvon; Raoult, Didier

    2010-01-01

    Background Recently, metagenomic studies have identified viable Pepper mild mottle virus (PMMoV), a plant virus, in the stool of healthy subjects. However, its source and role as pathogen have not been determined. Methods and Findings 21 commercialized food products containing peppers, 357 stool samples from 304 adults and 208 stool samples from 137 children were tested for PMMoV using real-time PCR, sequencing, and electron microscopy. Anti-PMMoV IgM antibody testing was concurrently performed. A case-control study tested the association of biological and clinical symptoms with the presence of PMMoV in the stool. Twelve (57%) food products were positive for PMMoV RNA sequencing. Stool samples from twenty-two (7.2%) adults and one child (0.7%) were positive for PMMoV by real-time PCR. Positive cases were significantly more likely to have been sampled in Dermatology Units (p<10?6), to be seropositive for anti-PMMoV IgM antibodies (p?=?0.026) and to be patients who exhibited fever, abdominal pains, and pruritus (p?=?0.045, 0.038 and 0.046, respectively). Conclusions Our study identified a local source of PMMoV and linked the presence of PMMoV RNA in stool with a specific immune response and clinical symptoms. Although clinical symptoms may be imputable to another cofactor, including spicy food, our data suggest the possibility of a direct or indirect pathogenic role of plant viruses in humans. PMID:20386604

  18. Effect of head and limb orientation on trunk muscle activation during abdominal hollowing in chronic low back pain

    PubMed Central

    2014-01-01

    Background Individuals with chronic low back pain (CLBP) have altered activations patterns of the anterior trunk musculature when performing the abdominal hollowing manœuvre (attempt to pull umbilicus inward and upward towards the spine). There is a subgroup of individuals with CLBP who have high neurocognitive and sensory motor deficits with associated primitive reflexes (PR). The objective of the study was to determine if orienting the head and extremities to positions, which mimic PR patterns would alter anterior trunk musculature activation during the hollowing manoeuvre. Methods This study compared surface electromyography (EMG) of bilateral rectus abdominis (RA), external oblique (EO), and internal obliques (IO) of 11 individuals with CLBP and evident PR to 9 healthy controls during the hollowing manoeuvre in seven positions of the upper quarter. Results Using magnitude based inferences it was likely (>75%) that controls had a higher ratio of left IO:RA activation with supine (cervical neutral), asymmetrical tonic neck reflex (ATNR) left and right, right cervical rotation and cervical extension positions. A higher ratio of right IO:RA was detected in the cervical neutral and ATNR left position for the control group. The CLBP group were more likely to show higher activation of the left RA in the cervical neutral, ATNR left and right, right cervical rotation and cervical flexion positions as well as in the cervical neutral and cervical flexion position for the right RA. Conclusions Individuals with CLBP and PR manifested altered activation patterns during the hollowing maneuver compared to healthy controls and that altering cervical and upper extremity position can diminish the group differences. Altered cervical and limb positions can change the activation levels of the IO and EO in both groups. PMID:24558971

  19. Postoperative pain and perioperative outcomes after laparoscopic radical hysterectomy and abdominal radical hysterectomy in patients with early cervical cancer: a randomised controlled trial

    PubMed Central

    2013-01-01

    Background Non-randomised studies have suggested that the postoperative complications of (Campos LS, Limberger LF, Stein AT, Kalil AN) laparoscopic radical hysterectomy are similar to those in abdominal radical hysterectomy. However, no study evaluating postoperative pain comparing both techniques has been published thus far. Our objective was to compare pain intensity and other perioperative outcomes between laparoscopic radical hysterectomy (LRH) and abdominal radical hysterectomy (ARH) in early cervical cancer. Methods This single centre, randomised, controlled trial enrolled 30 cervical cancer patients who were clinically staged IA2 with lymph vascular invasion and IB according to the FIGO (International Federation of Gynaecology and Obstetrics) classification, and underwent LRH or ARH between late 1999 and early 2004. Postoperative pain, as measured by a 10-point numerical rate scale, was considered the primary endpoint. Postoperative pain was assessed every six hours during a patient’s usual postoperative care. Perioperative outcomes were also registered. Both surgical techniques were executed by the same surgical team. Secondary outcomes included intraoperative and other postoperative surgicopathological factors and 5-year survival rates. Results IA2 patients with lymphatic vascular space invasion and IB cervical cancer patients were randomised to either the LRH group (16 patients) or the ARH group (14 patients). Four patients (25%) in the LRH group and 5 patients (36%) in the ARH group presented with transoperative or serious postoperative complications. All of the transoperative complications occurred in the LRH group. The relative risk of presenting with complications was 0.70; CI 95% (0.23–2.11); P?=?0.694. LRH group mean pain score was significantly lower than ARH after 36 h of observation (P?=?0.044; mean difference score: 1.42; 95% CI: 0.04–2.80). The survival results will be published elsewhere. Conclusions LRH provided lower pain scores after 36 h of observation in this series. The perioperative and serious postoperative complications ratios were comparable between the groups. Trial Registration NCT01258413 PMID:24028441

  20. Intravenous acetaminophen is superior to ketamine for postoperative pain after abdominal hysterectomy: results of a prospective, randomized, double-blind, multicenter clinical trial

    PubMed Central

    Faiz, Hamid Reza; Rahimzadeh, Poupak; Visnjevac, Ognjen; Behzadi, Behzad; Ghodraty, Mohammad Reza; Nader, Nader D

    2014-01-01

    Background In recent years, intravenously (IV) administered acetaminophen has become one of the most common perioperative analgesics. Despite its now-routine use, IV acetaminophen’s analgesic comparative efficacy has never been compared with that of ketamine, a decades-old analgesic familiar to obstetricians, gynecologists, and anesthesiologists alike. This doubleblind clinical trial aimed to evaluate the analgesic effects of ketamine and IV acetaminophen on postoperative pain after abdominal hysterectomy. Methods Eighty women aged 25–70 years old and meeting inclusion and exclusion criteria were randomly allocated into two groups of 40 to receive either IV acetaminophen or ketamine intraoperatively. Postoperatively, each patient had patient-controlled analgesia. Pain and sedation (Ramsay Sedation Scale) were documented based on the visual analog scale in the recovery room and at 4 hours, 6 hours, 12 hours, and 24 hours after the surgery. Hemodynamic changes, adverse medication effects, and the need for breakthrough meperidine were also recorded for both groups. Data were analyzed by repeated-measures analysis of variance. Results Visual analog scale scores were significantly lower in the IV acetaminophen group at each time point (P<0.05), and this group required significantly fewer doses of breakthrough analgesics compared with the ketamine group (P=0.039). The two groups had no significant differences in terms of adverse effects. Conclusion Compared with ketamine, IV acetaminophen significantly improved postoperative pain after abdominal hysterectomy. PMID:24465135

  1. Abdominal emergencies in the geriatric patient

    PubMed Central

    2014-01-01

    Abdominal pain is one of the most frequent reasons that elderly people visit the emergency department (ED). In this article, we review the deadliest causes of abdominal pain in this population, including mesenteric ischemia, abdominal aortic aneurysm, and appendicitis and potentially lethal non-abdominal causes. We also highlight the pitfalls in diagnosing, or rather misdiagnosing, these clinical entities. PMID:25635203

  2. Efficacy of Continuous Epidural Analgesia versus Total Intravenous Analgesia on Postoperative Pain Control in Endovascular Abdominal Aortic Aneurysm Repair: A Retrospective Case-Control Study

    PubMed Central

    Özdemir, Abdullah; Kazdal, H?z?r; Tu?cugil, Ersagun

    2014-01-01

    We reviewed our experience to compare the effectiveness of epidural analgesia and total intravenous analgesia on postoperative pain control in patients undergoing endovascular abdominal aortic aneurysm repair. Records of 32 patients during a 2-year period were retrospectively investigated. TIVA group (n = 18) received total intravenous anesthesia, and EA group (n = 14) received epidural anesthesia and sedation. Pain assessment was performed on all patients on a daily basis during rest and activity on postoperative days until discharge from ward using the numeric rating scale. Data for demographic variables, required anesthetic level, perioperative hemodynamic variables, postoperative pain, and morbidities were recorded. There were no relevant differences concerning hospital stay (TIVA group: 14.1?±?7.0, EA group: 13.5?±?7.1), perioperative blood pressure variability (TIVA group: 15.6?±?18.1, EA group: 14.8?±?11.5), and perioperative hemodynamic complication rate (TIVA group: 17%, EA group: 14%). Postoperative pain scores differed significantly (TIVA group: 5.4?±?0.9, EA group: 1.8?±?0.8, P < 0.001). Epidural anesthesia and postoperative epidural analgesia better reduce postoperative pain better compared with general anesthesia and systemic analgesia, with similar effects on hemodynamic status. PMID:24804201

  3. Breast MRI in Patients with Unilateral Bloody and Serous-Bloody Nipple Discharge: A Comparison with Galactography

    PubMed Central

    Manganaro, Lucia; D'Ambrosio, Ilaria; Gigli, Silvia; Di Pastena, Francesca; Tardioli, Stefano; Framarino, Marialuisa; Ballesio, Laura

    2015-01-01

    Purpose. Assessing the role of breast MRI compared to galactography in patients with unilateral bloody or serous-bloody nipple discharge. Materials and Methods. Retrospective study including 53 unilateral discharge patients who performed galactography and MRI. We evaluated the capability of both techniques in identifying pathology and distinguishing between nonmalignant and malignant lesions. Lesions BIRADS 1/2 underwent follow-up, while the histological examination after surgery has been the gold standard to assess pathology in lesions BIRADS 3/4/5. The ROC analysis was used to test diagnostic MRI and galactography ability. Results. After surgery and follow-up, 8 patients had no disease (15%), 23 papilloma (43%), 11 papillomatosis (21%), 5 ductal cancer in situ (10%), and 6 papillary carcinoma (11%) diagnoses. Both techniques presented 100% specificity; MRI sensitivity was 98% versus 49% of galactography. Considering MRI, we found a statistical association between mass enhancement and papilloma (P < 0.001; AUC 0.957; CI 0.888–1.025), ductal enhancement and papillomatosis (P < 0.001; AUC 0.790; CI 0.623–0.958), segmental enhancement and ductal cancer in situ (P = 0.007; AUC 0.750; CI 0.429–1.071), and linear enhancement and papillary cancer (P = 0.011). Conclusions. MRI is a valid tool to detect ductal pathologies in patients with suspicious bloody or serous-bloody discharge showing higher sensitivity and specificity compared to galactography. PMID:25685810

  4. Abdominal Pain Syndrome

    MedlinePLUS

    ... endoscopy uses a flexible tube with a television camera in its tip and a lighting system to ... endoscopy in which a capsule containing a tiny camera, broadcasting station and antenna sends pictures to a ...

  5. Pain

    MedlinePLUS

    ... Active Medical Research Studies on Pain (ClinicalTrials.gov) Multimedia NCCAM Intramural Pain Research Program Safety Information Remoufan ... News Press Releases Alerts & Advisories Events Highlighted Information Multimedia (Video, Images, and Audio) NCCIH Clinical Digest A ...

  6. Recurrent abdominal pain as the presentation of tumor necrosis factor receptor-associated periodic syndrome (TRAPS) in an Asian girl: a case report and review of the literature.

    PubMed

    Chen, Yun-Ju; Yu, Hsin-Hui; Yang, Yao-Hsu; Lau, Yu-Lung; Lee, Wen-I; Chiang, Bor-Luen

    2014-12-01

    Tumor necrosis factor receptor-associated periodic syndrome (TRAPS) is characterized by periodic fever, cutaneous rash, conjunctivitis, lymphadenopathy, abdominal pain, myalgia, and arthralgia. It is a rare autosomal dominant disease and strongly associated with heterozygous mutations in the tumor necrosis factor (TNF) receptor super family 1A (TNFRSF1A) gene. It is believed to be more common in Western countries than in Asian countries. Here, we present the case of a 14-year-old girl with periodic fever and abdominal pain with elevation of inflammatory markers for 2 years. After extensive work-up of infectious etiology with negative results, the diagnosis of TRAPS was made although no gene mutations were identified in the TNFRSF1A gene, MVK gene, and NALP3/CIAS1 gene. She had partial clinical response to corticosteroids and immunomodulatory agents. However, the treatment response to TNF-? inhibitor etanercept was dramatic. She has remained symptom free under regular weekly to biweekly etanercept treatment for 2 years. We also reviewed the related literature and summarized the data of 10 Asian cases of TRAPS. PMID:22921805

  7. Abdominal x-ray

    MedlinePLUS

    Abdominal film; X-ray - abdomen; Flat plate; KUB x-ray ... Diagnose a pain in the abdomen or unexplained nausea Identify suspected problems in the urinary system, such as a kidney stone Identify blockage in the intestine Locate ...

  8. Parental Influence on Children's Chronic Abdominal Pain Experiences: Exploring the Relationship between Parental Protective Behaviors and Child Quality of Life

    E-print Network

    Kessler, Emily D.

    2011-08-31

    Initial studies examining relationships between parent behaviors and child functioning in chronic pain populations have documented positive associations between parental protective behaviors and child somatic complaints, ...

  9. Pain

    MedlinePLUS

    ... women. For instance, after puberty, when sex hormone levels rise, girls start to have more migraines than boys. But other painful conditions, such as joint pain, don’t become more common in women until after menopause, when sex hormone levels drop. It’s not clear yet which hormones affect ...

  10. An Incidentally Found Inflamed Uterine Myoma Causing Low Abdominal Pain, Using Tc-99m-Tektrotyd Single Photon Emission Computed Tomography-CT Hybrid Imaging

    PubMed Central

    Schütz, Matthias; Bernt, Reinhard; Zwerina, Jochen; Haller, Joerg

    2013-01-01

    We report the case of a 50-year-old woman presented with a history of right hemicolectomy due to an ileocecal neuroendocrine tumor and left breast metastasis. Owing to a slightly elevated chromogranin A-level and lower abdominal pain, single photon emission computed tomography-computer tomography (SPECT-CT) was performed. There were no signs of recurrence on the SPECT-CT scan, but the patient was incidentally found to have an inflamed intramural myoma. We believe that the slightly elevated chromogranin A-level was caused by the hypertension that the patient presented. In the clinical context, this is a report of an inflamed uterine myoma seen as a false positive result detected by TC-99m-Tc-EDDA/HYNIC-Tyr3-Octreotide (Tektrotyd) SPECT-CT hybrid imaging. PMID:24043983

  11. Association of CTRC and SPINK1 gene variants with recurrent hospitalizations for pancreatitis or acute abdominal pain in lipoprotein lipase deficiency

    PubMed Central

    Tremblay, Karine; Dubois-Bouchard, Camélia; Brisson, Diane; Gaudet, Daniel

    2014-01-01

    Background: There are important inter-individual variations in the incidence and severity of acute pancreatitis in patients with severe hypertriglyceridemia. Several genes involved in triglyceride-rich lipoprotein metabolism or serine proteases pathways are known to influence the risk of pancreatitis. Aim: To evaluate the association between genes regulating serine proteases, chymotrypsin C (CTRC) and serine peptidase inhibitor kazal type1 (SPINK1), and recurrence of hospitalizations for acute pancreatitis or severe abdominal pain in patients with Lipoprotein Lipase Deficiency (LPLD), a rare and extreme monogenic model of severe hypertriglyceridemia and pancreatitis. Method: The CTRC and SPINK1 genes promoter and coding regions sequencing has been performed in a sample of 38 LPLD adults (22 men and 16 women) and 100 controls (53 men and 47 women). Estimation of the association of CTRC and SPINK1 gene variants or combinations of variants with history of hospitalizations for pancreatitis or acute abdominal pain in LPLD was investigated using non-parametric analyses with correction for multiple testing and logistic regression models controlling for age, gender, family history, and life habits. Results: Gene sequencing followed by genotype-stratified analyses of the CTRC and SPINK1 genes in LPLD and controls revealed a positive association between recurrence of hospitalizations and the rs545634 (CTRC)—rs11319 (SPINK1) combination [OR = 41.4 (CI: 2.0–848.0); p = 0.016]. In all models, a positive family history of pancreatitis was a significant predictor of recurrent hospitalizations independently of the contribution of SPINK1 or CTRC (p < 0.001). Conclusion: These results suggest that a positive family history of pancreatitis and genetic markers in the serine protease pathways could be associated with a risk of recurrent hospitalization for acute pancreatitis in severe hypertriglyceridemia due to LPLD. PMID:24795752

  12. C-reactive protein and white blood cell count as triage test between urgent and nonurgent conditions in 2961 patients with acute abdominal pain.

    PubMed

    Gans, Sarah L; Atema, Jasper J; Stoker, Jaap; Toorenvliet, Boudewijn R; Laurell, Helena; Boermeester, Marja A

    2015-03-01

    The purpose of this article is to assess the diagnostic accuracy of C-reactive protein (CRP) and white blood cell (WBC) count to discriminate between urgent and nonurgent conditions in patients with acute abdominal pain at the emergency department, thereby guiding the selection of patients for immediate diagnostic imaging.Data from 3 large published prospective cohort studies of patients with acute abdominal pain were combined in an individual patient data meta-analysis. CRP levels and WBC counts were compared between patients with urgent and nonurgent final diagnoses. Parameters of diagnostic accuracy were calculated for clinically applicable cutoff values of CRP levels and WBC count, and for combinations.A total of 2961 patients were included of which 1352 patients (45.6%) had an urgent final diagnosis. The median WBC count and CRP levels were significantly higher in the urgent group than in the nonurgent group (12.8?×10/L; interquartile range [IQR] 9.9-16) versus (9.3?×10/L; IQR 7.2-12.1) and (46?mg/L; IQR 12-100 versus 10?mg/L; IQR 7-26) (P?50?mg/L and WBC count >15?×10/L were combined; however, 85.3% of urgent cases was missed.A high CRP level (>50?mg/L) combined with a high WBC count (>15?×10/L) leads to the highest PPV. However, this applies only to a small subgroup of patients (8.7%). Overall, CRP levels and WBC count are insufficient markers to be used as a triage test in the selection for diagnostic imaging, even with a longer duration of complaints (>48?hours). PMID:25738473

  13. Clinical, Ultrasonographic, and Pathologic Characteristics of Patients with Chronic Right-lower-quadrant Abdominal Pain that May Benefit from Appendectomy

    Microsoft Academic Search

    Alain Chichom Mefire; Robert Tchounzou; Patrick M. Kuwong; Jean P. A. Atangana; Albert C. Lysinge; Eimo E. Malonga

    2011-01-01

    Background  Chronic pains of the right lower quadrant of the abdomen (RLQA) remain a challenging problem worldwide, especially in areas\\u000a with limited technical background; chronic appendicitis is still a subject of controversy. The aim of this study was to analyze\\u000a the clinical and paraclinical data of patients with chronic pains of RLQA who had an appendectomy performed.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  During a period of

  14. Gastrointestinal (GI) permeability is associated with trait anxiety in children with functional abdominal pain (FAP) and Irritable Bowel Syndrome (IBS)

    Technology Transfer Automated Retrieval System (TEKTRAN)

    FAP and IBS affect 10-15% of school age children and bear many physiological similarities to irritable bowel syndrome (IBS) in adults (e.g., functional pain, visceral hyperalgesia). Animal models of IBS have suggested a relationship between neonatal stress and increased GI permeability later in life...

  15. Intrarectal Lidocaine Is an Effective Treatment for Abdominal Pain Associated With Diarrhea-Predominant Irritable Bowel Syndrome

    Microsoft Academic Search

    G. Nicholas Verne; Arup Sen; Donald D. Price

    2005-01-01

    Irritable bowel syndrome (IBS) is one of the most common disorders seen by gastroenterologists. Visceral hypersensitivity is now well recognized as a clinical marker for the disease. Intrarectal lidocaine has been previously shown to decrease pain report from rectal distension in patients with IBS without any significant serum lidocaine levels. We conducted a prospective, double-blind, crossover trial on 10 patients

  16. Persistent abdominal pain caused by an inferior vena cava filter protruding into the duodenum and the aortic wall.

    PubMed

    Malgor, Rafael D; Hines, George L; Terrana, Lisa; Labropoulos, Nicos

    2012-08-01

    Inferior vena cava (IVC) filter placement has increased dramatically over the past 2 decades. Symptomatic duodenal perforation by IVC filters with involvement of the aorta is a very rare, but challenging, complication. We report a case of persistent atypical right upper quadrant pain secondary to duodenal and aortic perforation by an IVC filter treated with cavotomy for filter removal, primary repair of the duodenum, and extraction of prongs from the aorta. PMID:22627053

  17. Bloody nipple discharge in infancy--report of two cases.

    PubMed

    Nascimento, Marta; Portela, Alexandrina; Espada, Filipa; Fonseca, Marcelo

    2012-01-01

    Bloody nipple discharge (BND) in infancy is an exceptionally rare finding. We report the cases of two children who are 9 and 29 months old. The first case presented with 1 month of bilateral intermittent blood-stained nipple discharge with no other symptoms. The second case presented with 15 days of intermittent right BND and a small palpable mass, without obvious signs of inflammation. The coagulation and hormonal tests were within the age-appropriate reference ranges. Ultrasound examination was normal. Cytological evaluation of nipple discharge showed no malignant cells. Both patients had spontaneous symptoms resolution. BND in paediatric age is usually benign and self-limited and often related to mammary duct ectasia. Unnecessary invasive procedures or treatments should be avoided. PMID:22814989

  18. Pain relief for infants undergoing abdominal surgery: comparison of infusions of i.v. morphine and extradural bupivacaine.

    PubMed

    Wolf, A R; Hughes, D

    1993-01-01

    We have undertaken a prospective, randomized double-blind study to compare extradural bupivacaine infusions with i.v. morphine infusions for postoperative analgesia in 32 infants younger than 4 yr undergoing abdominal surgery. "Sham" extradural or i.v. catheters were used to maintain the blinded nature of the study. Both techniques provided adequate analgesia for most of the 36-h postoperative period; differences in the pattern or quality of the analgesia were not detected. Patients in the i.v. morphine group were significantly more sedated; this was accompanied by slower ventilatory frequencies (26.7 (SD 1.8) b.p.m.) compared with the extradural group (33.6 (1.3) b.p.m.). Similarly, oxygen saturation was significantly less (P < 0.01) in patients receiving morphine (medians and quartiles of 94.0 (93-96)% compared with 96.0 (93-96)%). Mean systolic arterial pressure was similar in the two groups and there were no life-threatening complications. The lack of sedation was troublesome in three patients in the extradural group. PMID:8431313

  19. Abdominal Migraine

    MedlinePLUS

    Home » Abdominal Migraine Abdominal Migraine Submitted by Admin on Wed, 2007-10-24 12:10 Abdominal migraine is one of the variants of migraine headache. This variant most typically occurs in children, ...

  20. Typhoid fever with severe abdominal pain: diagnosis and clinical findings using abdomen ultrasonogram, hematology-cell analysis and the Widal test.

    PubMed

    Arjunan, Maripandi; Al-Salamah, Ali A

    2010-09-01

    A six-year-old boy with high-grade fever and abdominal pain in the epigastric region was examined with ultrasonogram of the abdomen. Hematology-cell analysis, serology (Widal test), urine analysis, and blood cultures were also performed. The ultrasonogram was helpful for the identification of multiple organ involvement with Salmonella typhi. The results revealed mild hepatosplenomegaly, minimal ascitis, and mesenteric lympoadenopathy. Hematological analysis showed a white blood count of 6,300 cells mL-1; a red blood cell count of 4.54 million/cu mm. The erythrocyte sedimentation rate (ESR) was 24 mm/1 hr; hemoglobin level of 11.5 g/dl; and a platelet count of 206,000 cells/mL. The patient's serum was agglutinated with lipopolysaccharide (TO), the titre value was 1:320 dilution, and flagellar antigen (TH) titre was 1:640. The patient was diagnosed with typhoid fever. Ceftriaxone was given intravenously for five days and the patient fully recovered. PMID:21045376

  1. Wound infiltration with plain bupivacaine as compared with bupivacaine fentanyl mixture for postoperative pain relief after abdominal surgery

    PubMed Central

    Chander, Reetika; Liddle, Dootika; Kaur, Baljinder; Varghese, Mary

    2011-01-01

    Aim: To compare the efficacy of wound infiltration with Bupivacaine or Bupivacaine with fentanyl for post operative analgesia. Background: The role of Bupivacaine and fentanyl mixture as wound infiltration for post operative analgesia is less explored in human subjects. Materials and Methods: This prospective, randomized included 60 ASA grade I, II, and III patients in the age group of 20-75 years of age. The patients were randomized into two groups of 30 patients each: Group A received wound infiltration with a solution containing 0.5% bupivacaine (2 mg/kg), while, Group B received infiltration with a solution containing fentanyl 25 ?g added to 0.5% bupivacaine (2 mg/kg). Results: None of the patients in both groups had unbearable incisional pain but addition of fentanyl to 0.5% bupivacaine reduced analgesic consumption in the postoperative period (P<0.05). Conclusion: Addition of opioids to local anesthetics results in better postoperative analgesia and reduced opioid requirement post operatively.

  2. Abdominal Cystic Lymphangioma Mimicking Appendicitis

    PubMed Central

    Wake, Sarah; Abhyankar, Aruna; Hutton, Kim

    2013-01-01

    A cystic lymphangioma arising within the abdomen is a rare entity in children. It may present with an abdominal mass and symptoms of abdominal pain, vomiting, and anorexia. These nonspecific clinical symptoms are often attributed to more common acute pediatric conditions. In this report, we describe two pediatric cases of intra-abdominal cystic lymphangioma that were initially diagnosed and treated as appendicitis. True diagnosis was only achieved on surgical excision and pathological investigation of cystic material.

  3. Ruptured abdominal aortic aneurysm diagnosed through non-contrast MRI

    PubMed Central

    Chatra, Priyank S

    2013-01-01

    Rupture of an aneurysm is a rare complication although it is considered a common cause of death. Some of these patients present with the classic triad of symptoms such as abdominal pain, pulsatile abdominal mass and shock. Most symptoms are misleading and will only present as vague abdominal pain. Here we describe one such patient with an unusual presentation of a misleading abdominal mass which was eventually diagnosed as a ruptured abdominal aortic aneurysm after an emergency MRI. PMID:25003065

  4. Fluorescence enhancement of a latent bloody footprint sprayed with mercurochrome reagent

    NASA Astrophysics Data System (ADS)

    Liang, E. J.; Shen, Shu-po; Zheng, Dayue; Zhu, Y.; Yuan, B.; Song, H. Q.

    1992-02-01

    An argon ion laser together with mercurochrome reagent is used in the detection of a latent bloody footprint. Fluorescence from a latent bloody footprint sprayed with mercurochrome solution is significantly enhanced relative to that from the background under laser illumination. Absorption spectral and chromatographic study shows that fluorescence enhancement results from the resonance photon absorption in a new substances created through chemical reactions between blood and mercurochrome.

  5. Premedication with gabapentin, alprazolam or a placebo for abdominal hysterectomy: Effect on pre-operative anxiety, post-operative pain and morphine consumption

    PubMed Central

    Joseph, Tim Thomas; Krishna, Handattu Mahabaleswara; Kamath, Shyamsunder

    2014-01-01

    Background and Aims: Utility of gabapentin for pre-operative anxiolysis as compared to commonly administered alprazolam is not evident. The aim of the present study was to compare the effects of pre-operative oral gabapentin 600 mg, alprazolam 0.5 mg or a placebo on pre-operative anxiety along with post-operative pain and morphine consumption. Methods: Seventy five patients scheduled for abdominal hysterectomy under general anaesthesia were included. Groups gabapentin, alprazolam and placebo, received oral gabapentin 600 mg, alprazolam 0.5 mg and one capsule of oral B-complex forte with Vitamin C respectively, on the night prior to surgery and 2 h prior to surgery. Visual analogue scale (VAS) was used to measure the anxiety and post-operative pain. All patients received patient-controlled analgesia. Statistical tests used were Kruskal–Wallis test, Wilcoxon signed rank test and one-way ANOVA. Results: Alprazolam provided significant anxiolysis (median [interquartile range] baseline VAS score 35 [15.5, 52] to 20 [6.5, 34.5] after drug administration; P = 0.007). Gabapentin did not provide significant decrease in anxiety (median [interquartile range] VAS score 21 [7.5, 41] to 20 [6.5, 34.5]; P = 0.782). First analgesic request time (median [interquartile range in minutes]) was longer in group gabapentin (17.5 [10, 41.25]) compared to group placebo (10 [5, 15]) (P = 0.019) but comparable to that in group alprazolam (15 [10, 30]). Cumulative morphine consumption at different time periods and total morphine consumption (mean [standard deviation]) at the end of study period (38.65 [18.04], 39.91 [15.73], 44.29 [16.02] mg in group gabapentin, alprazolam and placebo respectively) were comparable. Conclusion: Gabapentin 600 mg does not have significant anxiolytic effect compared to alprazolam 0.5 mg. Alprazolam 0.5 mg was found to be an effective anxiolytic in the pre-operative period. Neither alprazolam nor gabapentin, when compared to placebo showed any opioid sparing effects post-operatively. PMID:25624531

  6. Idiopathic Focal Eosinophilic Enteritis (IFEE), an Emerging Cause of Abdominal Pain in Horses: The Effect of Age, Time and Geographical Location on Risk

    PubMed Central

    Archer, Debra C.; Costain, Deborah A.; Sherlock, Chris

    2014-01-01

    Background Idiopathic focal eosinophilic enteritis (IFEE) is an emerging cause of abdominal pain (colic) in horses that frequently requires surgical intervention to prevent death. The epidemiology of IFEE is poorly understood and it is difficult to diagnose pre-operatively. The aetiology of this condition and methods of possible prevention are currently unknown. The aims of this study were to investigate temporal and spatial heterogeneity in IFEE risk and to ascertain the effect of horse age on risk. Methodology/Principal Findings A retrospective, nested case-control study was undertaken using data from 85 IFEE cases and 848 randomly selected controls admitted to a UK equine hospital for exploratory laparotomy to investigate the cause of colic over a 10-year period. Generalised additive models (GAMs) were used to quantify temporal and age effects on the odds of IFEE and to provide mapped estimates of ‘residual’ risk over the study region. The relative risk of IFEE increased over the study period (p?=?0.001) and a seasonal pattern was evident (p<0.01) with greatest risk of IFEE being identified between the months of July and November. IFEE risk decreased with increasing age (p<0.001) with younger (0–5 years old) horses being at greatest risk. The mapped surface estimate exhibited significantly atypical sub-regions (p<0.001) with increased IFEE risk in horses residing in the North-West of the study region. Conclusions/Significance IFEE was found to exhibit both spatial and temporal variation in risk and is more likely to occur in younger horses. This information may help to identify horses at increased risk of IFEE, provide clues about the aetiology of this condition and to identify areas that require further research. PMID:25463382

  7. Large Abdominal Wall Endometrioma Following Laparoscopic Hysterectomy

    PubMed Central

    Borncamp, Erik; Mehaffey, Philip; Rotman, Carlos

    2011-01-01

    Background: Endometriosis is a common condition in women that affects up to 45% of patients in the reproductive age group by causing pelvic pain. It is characterized by the presence of endometrial tissue outside the uterine cavity and is rarely found subcutaneously or in abdominal incisions, causing it to be overlooked in patients with abdominal pain. Methods: A 45-year-old woman presented with lower abdominal pain 2 years following a laparoscopic supracervical hysterectomy. She was found to have incidental cholelithiasis and a large abdominal mass suggestive of a significant ventral hernia on CT scan. Results: Due to the peculiar presentation, surgical intervention took place that revealed a large 9cm×7.6cm×6.2cm abdominal wall endometrioma. Conclusion: Although extrapelvic endometriosis is rare, it should be entertained in the differential diagnosis for the female patient who presents with an abdominal mass and pain and has a previous surgical history. PMID:21902990

  8. Functional Abdominal Pain in Children

    MedlinePLUS

    ... IBD) such as Crohn’s disease and ulcerative colitis, celiac disease which is a sensitivity to cereal grains, food ... of certain infections and disorders like IBD and celiac disease. Normal test results in a child without alarm ...

  9. Sonographic findings in abdominal hereditary angioedema.

    PubMed

    Sofia, S; Casali, A; Bolondi, L

    1999-01-01

    Patients with hereditary angioedema (HAE) may suffer from abdominal pain severe enough to prompt unnecessary surgical intervention. The diagnostic approach to abdominal pain during HAE attacks is not established. We describe abdominal sonographic findings during severe colic in 2 patients with known HAE. Sonography demonstrated marked mucosal thickening and edema of the bowel wall with a variable amount of free peritoneal fluid. These findings are not specific but are consistent with the hypothesized mechanism of attack and resolve after therapy. Abdominal sonography is useful for evaluating acute abdominal pain in patients with known HAE to prevent unnecessary surgery. Conversely, if the described sonographic findings appear in a case of abdominal colic of unknown origin, HAE should be included in the differential diagnosis. PMID:10525217

  10. Pulmonary thromboembolism presenting with abdominal symptoms

    PubMed Central

    Mansmann, Erin H.; Singh, Anil

    2012-01-01

    Summary Background: Abdominal pain is rarely reported as the presenting complaint of pulmonary thromboembolism. Case Report: We report a case of a 42 year old white male with no known past medical problems except a left humeral fracture two weeks prior who presented to the emergency department with acute onset of right flank and lower abdominal pain. Initial evaluation including abdominal CT suggested cholecystitis. Lack of improvement with empiric antibiotics and symptomatic therapy prompted further evaluation revealing the patient to have a pulmonary thromboembolism (PTE). Conclusions: Pulmonary thromboembolism (PTE) can be effectively treated once diagnosed. Abdominal pain as a presenting complaint in PTE is rarely reported as a cause of PTE. We believe that clinicians should consider PTE in their differential of abdominal pain in patients with risk factors for VTE. PMID:23569510

  11. Gut-directed hypnotherapy in children with irritable bowel syndrome or functional abdominal pain (syndrome): a randomized controlled trial on self exercises at home using CD versus individual therapy by qualified therapists

    PubMed Central

    2014-01-01

    Background Irritable bowel syndrome (IBS) and functional abdominal pain (syndrome) (FAP(S)) are common pediatric disorders, characterized by chronic or recurrent abdominal pain. Treatment is challenging, especially in children with persisting symptoms. Gut-directed hypnotherapy (HT) performed by a therapist has been shown to be effective in these children, but is still unavailable to many children due to costs, a lack of qualified child-hypnotherapists and because it requires a significant investment of time by child and parent(s). Home-based hypnotherapy by means of exercises on CD has been shown effective as well, and has potential benefits, such as lower costs and less time investment. The aim of this randomized controlled trial (RCT) is to compare cost-effectiveness of individual HT performed by a qualified therapist with HT by means of CD recorded self-exercises at home in children with IBS or FAP(S). Methods/Design 260 children, aged 8-18 years with IBS or FAP(S) according to Rome III criteria are included in this currently conducted RCT with a follow-up period of one year. Children are randomized to either 6 sessions of individual HT given by a qualified therapist over a 3-month period or HT through self-exercises at home with CD for 3 months. The primary outcome is the proportion of patients in which treatment is successful at the end of treatment and after one year follow-up. Treatment success is defined as at least 50% reduction in both abdominal pain frequency and intensity scores. Secondary outcomes include adequate relief, cost-effectiveness and effects of both therapies on depression and anxiety scores, somatization scores, QoL, pain beliefs and coping strategies. Discussion If the effectiveness of home-based HT with CD is comparable to, or only slightly lower, than HT by a therapist, this treatment may become an attractive form of therapy in children with IBS or FAP(S), because of its low costs and direct availability. Trial registration Dutch Trial Register number NTR2725 (date of registration: 1 February 2011) PMID:24894077

  12. Single vessel abdominal arterial disease.

    PubMed

    van Noord, Désirée; Kuipers, Ernst J; Mensink, Peter B F

    2009-01-01

    The long-standing discussion concerning the mere existence of single vessel abdominal artery disease can be closed: chronic gastrointestinal ischaemia (CGI) due to single vessel abdominal artery stenosis exists, can be treated successfully and in a safe manner. The most common causes of single vessel CGI are the coeliac artery compression syndrome (CACS) in younger patients, and atherosclerotic disease in elderly patients. The clinical symptoms of single vessel CGI patients are postprandial and exercise-related pain, weight loss, and an abdominal bruit. The current diagnostic approach in patients suspected of single vessel CGI is gastrointestinal tonometry combined with radiological visualisation of the abdominal arteries to define possible arterial stenosis. Especially in single vessel abdominal artery stenosis, gastrointestinal tonometry plays a pivotal role in establishing the diagnosis CGI. First-choice treatment of single vessel CGI remains surgical revascularisation, especially in CACS. In elderly or selected patients endovascular stent placement therapy is an acceptable option. PMID:19258186

  13. Cosmogenic Chlorine36 Chronology for Glacial Deposits at Bloody Canyon, Eastern Sierra Nevada

    Microsoft Academic Search

    Fred M. Phillips; Marek G. Zreda; Stewart S. Smith; David Elmore; Peter W. Kubik; Pankaj Sharma

    1990-01-01

    Deposits from mountain glaciers provide an important record of Quaternary climatic fluctuations but have proved difficult to date directly. A chronology has been obtained for glacial deposits at Bloody Canyon, California, by measurement of the accumulation of chlorine-36 produced by cosmic rays in boulders exposed on moraine crests. The accumulation of chlorine-36 indicates that episodes of glaciation occurred at about

  14. Citizen protest in the online networks: the case of the China's bloody map

    E-print Network

    Boyer, Edmond

    Citizen protest in the online networks: the case of the China's bloody map Research purpose. But what makes the Internet a powerful and dreaded tool in censorship environments is his potential the use of Internet is subject to censorship transmitted around the world? Which network is created

  15. Abdominal aortic aneurysms: case report

    PubMed Central

    Hadida, Camille; Rajwani, Moez

    1998-01-01

    A 71-year-old male presented to a chiropractic clinic with subacute low back pain. While the pain appeared to be mechanical in nature, radiographic evaluation revealed an abdominal aortic aneurysm, which required the patient to have vascular surgery. This case report illustrates the importance of the history and physical examination in addition to a thorough knowledge of the features of abdominal aortic aneurysms. The application of spinal manipulative therapy in patients with (AAA) is also discussed. ImagesFigure 1Figure 2Figure 3

  16. Do we really need additional contrast-enhanced abdominal computed tomography for differential diagnosis in triage of middle-aged subjects with suspected biliary pain.

    PubMed

    Hwang, In Kyeom; Lee, Yoon Suk; Kim, Jaihwan; Lee, Yoon Jin; Park, Ji Hoon; Hwang, Jin-Hyeok

    2015-02-01

    Enhanced computed tomography (CT) is widely used for evaluating acute biliary pain in the emergency department (ED). However, concern about radiation exposure from CT has also increased. We investigated the usefulness of pre-contrast CT for differential diagnosis in middle-aged subjects with suspected biliary pain.A total of 183 subjects, who visited the ED for suspected biliary pain from January 2011 to December 2012, were included. Retrospectively, pre-contrast phase and multiphase CT findings were reviewed and the detection rate of findings suggesting disease requiring significant treatment by noncontrast CT (NCCT) was compared with cases detected by multiphase CT.Approximately 70% of total subjects had a significant condition, including 1 case of gallbladder cancer and 126 (68.8%) cases requiring intervention (122 biliary stone-related diseases, 3 liver abscesses, and 1 liver hemangioma). The rate of overlooking malignancy without contrast enhancement was calculated to be 0% to 1.5%. Biliary stones and liver space-occupying lesions were found equally on NCCT and multiphase CT. Calculated probable rates of overlooking acute cholecystitis and biliary obstruction were maximally 6.8% and 4.2% respectively. Incidental significant finding unrelated with pain consisted of 1 case of adrenal incidentaloma, which was also observed in NCCT.NCCT might be sufficient to detect life-threatening or significant disease requiring early treatment in young adults with biliary pain. PMID:25700321

  17. The NOTA study: non-operative treatment for acute appendicitis: prospective study on the efficacy and safety of antibiotic treatment (amoxicillin and clavulanic acid) in patients with right sided lower abdominal pain

    PubMed Central

    Giorgini, Eleonora; Biscardi, Andrea; Villani, Silvia; Clemente, Nicola; Senatore, Gianluca; Filicori, Filippo; Antonacci, Nicola; Baldoni, Franco; De Werra, Carlo; Di Saverio, Salomone

    2011-01-01

    Background Case control studies that randomly assign patients with diagnosis of acute appendicitis to either surgical or non-surgical treatment yield a relapse rate of approximately 14% at one year. It would be useful to know the relapse rate of patients who have, instead, been selected for a given treatment based on a thorough clinical evaluation, including physical examination and laboratory results (Alvarado Score) as well as radiological exams if needed or deemed helpful. If this clinical evaluation is useful, the investigators would expect patient selection to be better than chance, and relapse rate to be lower than 14%. Once the investigators have established the utility of this evaluation, the investigators can begin to identify those components that have predictive value (such as blood analysis, or US/CT findings). This is the first step toward developing an accurate diagnostic-therapeutic algorithm which will avoid risks and costs of needless surgery. Methods/design This will be a single-cohort prospective observational study. It will not interfere with the usual pathway, consisting of clinical examination in the Emergency Department (ED) and execution of the following exams at the physician's discretion: full blood count with differential, C reactive protein, abdominal ultrasound, abdominal CT. Patients admitted to an ED with lower abdominal pain and suspicion of acute appendicitis and not needing immediate surgery, are requested by informed consent to undergo observation and non operative treatment with antibiotic therapy (Amoxicillin and Clavulanic Acid). The patients by protocol should not have received any previous antibiotic treatment during the same clinical episode. Patients not undergoing surgery will be physically examined 5 days later. Further follow-up will be conducted at 7, 15 days, 6 months and 12 months. The study will conform to clinical practice guidelines and will follow the recommendations of the Declaration of Helsinki. The protocol was approved on November 2009 by Maggiore Hospital Ethical Review Board (ID CE09079). Trial Registration ClinicalTrials.gov identifier: NCT01096927. PMID:22021722

  18. Urine - bloody

    MedlinePLUS

    ... sickle cell, bleeding problems, and other blood disorders Urinalysis Urinary cytology Urine culture 24-hour urine collection ... the urologic patient: History, physical examination, and the urinalysis In: Wein AJ, ed. Campbell-Walsh Urology . 10th ...

  19. Abdominal rigidity

    MedlinePLUS

    Rigidity of the abdomen ... is a sore area inside the belly or abdomen, the pain will get worse when a hand ... Abscess inside the abdomen Appendicitis Cholecystitis caused by ... the entire wall of the stomach, small intestine, large bowel, ...

  20. Abdominal mass

    MedlinePLUS

    Mass in the abdomen ... the doctor make a diagnosis. For example, the abdomen is usually divided into four areas: Right-upper ... pain or masses include: Epigastric -- center of the abdomen just below the rib cage Periumbilical -- area around ...

  1. Fluorescence-lifetime molecular imaging can detect invisible peritoneal ovarian tumors in the bloody ascites

    PubMed Central

    Nakajima, Takahito; Sano, Kohei; Sato, Kazuhide; Watanabe, Rira; Harada, Toshiko; Hanaoka, Hirofumi; Choyke, Peter L.; Kobayashi, Hisataka

    2014-01-01

    Summary The blood contamination, such as bloody ascites or hemorrhages during surgeries, is a potential hazard for clinical application of fluorescence imaging. In order to overcome this problem, we investigate if fluorescence lifetime imaging helps overcoming this problem. Samples were prepared at the concentration ranging from 0.3 to 2.4 ?M and mixed with ranging from 0 to 10% of blood. Fluorescence intensities and lifetimes of samples were measured by a time-domain fluorescence imager. An ovarian cancer SHIN3 cells overexpressing D-galactose receptor were injected into peritoneal cavity 2.5 weeks before the experiments. Galactosyl serum albumin-rhodamine green (GSA-RhodG), which bound to D-galactose receptor and internalized thereafter, was administered intrapenitoneally to peritoneal ovarian cancer-bearing mice with various degrees of bloody ascites. In vitro study showed a linear correlation between fluorescence intensity and probe concentration (r2>0.99) whereas the fluorescence lifetime was consistent (range; 3.33 ± 0.15 to 3.75 ± 0.04 ns). By adding 10% of blood to samples, fluorescence intensities decreased to less than 1%, while fluorescence lifetimes were consistent. In vivo fluorescence lifetime of GSA-RhodG stained tumors was longer than auto-fluorescence lifetime (threshold: 2.87 ns). Tumor lesions under hemorrhagic peritonitis were not depicted by fluorescence intensity imaging, however, fluorescence lifetime imaging clearly detected tumor lesions by prolonged lifetimes. In conclusion, fluorescence lifetime imaging with GSA-RhodG depicted ovarian cancer lesions, which were invisible in intensity images, in hemorrhagic ascites. Fluorescence lifetime imaging would help fluorescence-guided navigation surgery when bloody fluid contaminates the field of view. PMID:24479901

  2. [A case of ischemic colitis presenting as bloody diarrhea after normal saline enema].

    PubMed

    Park, Ji Eun; Moon, Won; Nam, Ji Hyun; Kim, Nang Hee; Kim, Sung Hoon; Park, Moo In; Park, Seun Ja; Kim, Kyu Jong

    2007-08-01

    Ischemic colitis is a frequent disorder of large bowel in elderly persons or in debilitated patients with a variable underlying medical problems. Ischemic colitis may result from alterations in the systemic circulation or anatomic or functional changes in the local mesenteric vasculature. In most cases, no specific cause for the ischemic colitis is identified. Cases of ischemic colitis after enema for bowel cleansing have been rarely reported, but there has been no case report after normal saline enema. We report a case of ischemic colitis in a 72-year old patient with well-controlled hypertension, presenting as bloody diarrhea which developed after normal saline enema for preoperative bowel cleansing. PMID:17928757

  3. Neuropathic pain in hereditary coproporphyria

    PubMed Central

    Chen, Guan-Liang; Yang, Deng-Ho; Wu, Jeng-Yuau; Kuo, Chia-Wen; Hsu, Wen-Hsiu

    2013-01-01

    Acute porphyrias are rare diseases with varying incidences worldwide. These diseases are disorders of heme biosynthesis characterized by acute attacks of neurological symptoms. Acute porphyria should be considered in patients with unexplained abdominal pain or neurological damage. Clinical manifestations of acute porphyria are nonspecific and are associated with multiple organ systems. This report examines a rare case of an uncommon type of acute porphyria in a patient with an initial presentation of abdominal pain and progressive polyneuropathy. PMID:24353603

  4. Role of the sympathetic nervous system in pain

    Microsoft Academic Search

    Mick Serpell

    2005-01-01

    Some chronic pain conditions appear to be sympathetically mediated because interruption of the sympathetic supply results in pain relief. Examples include: complex regional pain syndrome type I and II; visceral pain due to abdominal and pelvic cancers; ischaemic pain or tissue viability from peripheral vascular disease, arterial spasm or frostbite; ischaemic heart disease; post-herpetic neuralgia; erythromelalgia. The sympathetic ganglion can

  5. Chronic Pain: The Impact on Academic, Social, and Emotional Functioning

    ERIC Educational Resources Information Center

    Parkins, Jason M.; Gfroerer, Susan D.

    2009-01-01

    Chronic pain is persistent and recurrent pain that tends to fluctuate in severity, quality, regularity, and predictability. It can occur in a single or multiple body regions or organ systems. Some of the most frequently reported types of chronic pain include headaches, recurrent abdominal pain (RAP), and musculoskeletal pain. In contrast to acute…

  6. Chronic non-bloody diarrhoea: a prospective study in Malmö, Sweden, with focus on microscopic colitis

    PubMed Central

    2014-01-01

    Background Chronic non-bloody diarrhoea affects up to 5% of the population. Microscopic colitis is one of the most common causes, encompassing the subtypes collagenous colitis and lymphocytic colitis. The diagnosis of microscopic colitis is made by histological examination of colonic mucosal biopsy specimens. The aim of this investigation was to determine whether laboratory parameters or questions about disease history or concomitant disease could be helpful in discriminating patients with MC from those with a histologically normal colonic mucosa. Findings Patients admitted for colonoscopy because of chronic non-bloody diarrhoea (>2 loose stools for >3 weeks) at endoscopy units in Malmö during 2007 and 2009, were enrolled. A total number of 78 patients were included (60 women, 18 men, median age 59, IQR 45–69 years). Out of these 78, 15 patients (19%) had microscopic colitis (CC; n?=?10, LC; n?=?5). MC was especially prevalent in patients above the age of 50 (25%). No differences were found between those with normal histology and MC in laboratory analyses (inflammatory and liver parameters). Neither were differences shown in questions regarding symptoms, environmental factors or concomitant diseases except for an association with celiac disease (p?=?0.019) and a trend maybe indicating an inverse association with appendectomy (p?=?0.057). Conclusions Microscopic colitis is associated with female gender, celiac disease and consumption of NSAIDs. Trends were observed indicating that age above 50 years, acute onset and absence of appendectomy may be associated with MC. No associations were observed with other symptoms, calprotectin levels or liver parameters. PMID:24731750

  7. Cross-sectional analysis of the possible relationship between lead exposure in the storage-battery industry and changes in biochemical markers of renal, hematopoietic, and hepatic functioning and the reporting of recent abdominal pain

    SciTech Connect

    Zelenak, J.P.

    1986-01-01

    There is extensive literature documenting the physical effects, such as renal impairment and disruption of hematopoiesis, of lead exposure in occupational cohorts. In addition, a small number of case studies have suggested that lead exposure might result in hepatocellular effects. This study was undertaken to determine if these effects still existed for a population of lead storage battery workers exposed to occupational lead exposures which were lower than those experienced by most lead workers prior to 1978. The relationship between the lead exposure indices,zinc protoporphyrin (ZPP) and a time weighted average blood lead measure (TWA), with twelve biochemical parameters indicative of renal, hematopoietic and hepatic functioning and the reporting of recent abdominal pain was investigated. In addition, the possible modifying effects of alcohol consumption and duration of exposure on the relationship between lead exposure and the biochemical parameters were examined. The subjects for this analysis consisted of 288 lead workers form three lead storage battery plants and a group of 181 workers employed in an industry which did not involve lead exposure. The study was conducted from 1982-83. Comparisons of the lead exposure indices with the dependent variables were made through univariate correlational and hierarchical regression analyses. The lead exposure index, ZPP, was significantly associated wit BUN levels, though less than three percent of the lead and control workers had BUN levels above the normal range, In addition, NPP, was negatively associated with hemoglobin levels at probability levels between 0.052 and 0.055. Furthermore, there were no hemoglobin levels outside of the normal range for any of the sites studied. The other lead exposure index, TWA, was significantly associated with alkaline phosphatase and triglycerides. However, these analyses were not age-adjusted.

  8. Laparoscopic diagnosis of blunt abdominal trauma in children

    Microsoft Academic Search

    T. Hasegawa; Y. Miki; Y. Yoshioka; S. Mizutani; T. Sasaki; J. Sumimura

    1997-01-01

    This study evaluates the safety and role of laparoscopy in the diagnosis of blunt abdominal trauma in children. Laparoscopy was performed in five patients aged 3 to 13 years because of persistent abdominal pain after blunt trauma. A laparotomy was not indicated from the physical examination, laboratory data, or radiologic findings. With the patient under general anesthesia, a 10-mm trocar

  9. Acute appendicitis presenting as unusual left upper quadrant pain.

    PubMed

    Chuang, Tsung-Ju; Chen, Chun-Wen; Lin, Hsin-Yuan; Hsu, Wen-Hsiu; Wang, Shou-Cheng; Tu, Chuan-Chou

    2013-09-01

    Appendicitis is the most common abdominal disease that requires surgery in the emergency ward. It usually presents as right lower quadrant pain, but may rarely present as left upper quadrant (LUQ) pain due to congenital anatomical abnormalities of the intestine. We report a patient who complained of persistent LUQ abdominal pain and was finally diagnosed by computed tomography (CT) as congenital intestinal malrotation complicated with acute appendicitis. It is important to include acute appendicitis in the differential diagnosis of patients who complain of LUQ abdominal pain. Abdominal CT can provide significant information that is useful in preoperative diagnosis and determination of proper treatment. PMID:24348602

  10. Jejunal perforation caused by abdominal angiostrongyliasis.

    PubMed

    Waisberg, J; Corsi, C E; Rebelo, M V; Vieira, V T; Bromberg, S H; dos Santos, P A; Monteiro, R

    1999-01-01

    The authors describe a case of abdominal angiostrongyliasis in an adult patient presenting acute abdominal pain caused by jejunal perforation. The case was unusual, as this affliction habitually involves the terminal ileum, appendix, cecum or ascending colon. The disease is caused by the nematode Angiostrongylus costaricensis, whose definitive hosts are forest rodents while snails and slugs are its intermediate hosts. Infection in humans is accidental and occurs via the ingestion of snail or slug mucoid secretions found on vegetables, or by direct contact with the mucus. Abdominal angiostrongyliasis is clinically characterized by prolonged fever, anorexia, abdominal pain in the right-lower quadrant, and peripheral blood eosinophilia. Although usually of a benign nature, its course may evolve to more complicated forms such as intestinal obstruction or perforation likely to require a surgical approach. Currently, no efficient medication for the treatment of abdominal angiostrongyliasis is known to be available. In this study, the authors provide a review on the subject, considering its etiopathogeny, clinical picture, diagnosis and treatment. PMID:10602548

  11. Wet powder suspensions as an additional technique for the enhancement of bloodied marks.

    PubMed

    Au, Catherine; Jackson-Smith, Hayley; Quinones, Ignacio; Jones, B J; Daniel, Barbara

    2011-01-30

    The enhancement of marks in blood on dark surfaces poses significant challenges to the forensic scientist. Current methods of enhancement include the sequential use of acid dyes (acid yellow, acid violet and acid black). Acid yellow is used to greatest effect on lighter deposits of blood on a non-porous background, and is visualised using a light source which causes it to fluoresce [1]. However, further enhancement with acid violet and acid black produces a dark product which may fail to improve the contrast of the mark against a dark background. The use of wet powder suspensions (WPSs) has been proposed as a complementary procedure for use in fingermark enhancement, beyond its typical use in the enhancement of marks on adhesive surfaces. In this investigation, the use of WPS was tested in conjunction with conventional acid dye treatments on marks in blood deposited on a selection of substrates. The results demonstrated that white WPS alone or together with acid dyes results in an overall enhancement of mark quality (p<0.005) on marks deposited on smooth non-porous surfaces. The technique was shown to not interfere with subsequent presumptive tests on blood. However WPS treatments were shown to reduce the amount of DNA recoverable from the marks, resulting on an average decrease of 91% compared to untreated controls. The decline in DNA yields was shown to result in a decrease in the quality of the DNA profiles obtained. The enhancement properties of WPS were evaluated by electron microscopy. It was shown that the titanium dioxide particles in the WPS primarily interact with the non-bloodied part of the mark, thus producing a contrasting effect with the background and acid dyes. PMID:20494531

  12. Identification of the Bloody Creek structure, a possible impact crater in southwestern Nova Scotia, Canada

    NASA Astrophysics Data System (ADS)

    Spooner, Ian; Stevens, George; Morrow, Jared; Pufahl, Peir; Grieve, Richard; Raeside, Rob; Pilon, Jean; Stanley, Cliff; Barr, Sandra; McMullin, David

    2009-08-01

    An approximately 0.4 km diameter elliptical structure formed in Devonian granite in southwestern Nova Scotia, herein named the Bloody Creek structure (BCS), is identified as a possible impact crater. Evidence for an impact origin is based on integrated geomorphic, geophysical, and petrographic data. A near-continuous geomorphic rim and a 10 m deep crater that is infilled with lacustrine sediments and peat define the BCS. Ground penetrating radar shows that the crater has a depressed inner floor that is sharply ringed by a 1 m high buried scarp. Heterogeneous material under the floor, interpreted as deposits from collapse of the transient cavity walls, is overlain by stratified and faulted lacustrine and wetland sediments. Alteration features found only in rim rocks include common grain comminution, polymict lithic microbreccias, kink-banded feldspar and biotite, single and multiple sets of closely spaced planar microstructures (PMs) in quartz and feldspar, and quartz mosaicism, rare reduced mineral birefringence, and chlorite showing plastic deformation and flow microtextures. Based on their form and crystallographic orientations, the quartz PMs consist of planar deformation features that document shock-metamorphic pressures ?25 GPa. The age of the BCS is not determined. The low depth to diameter ratio of the crater, coupled with anomalously high shock-metamorphic pressures recorded at its exposed rim, may be a result of significant post-impact erosion. Alternatively, impact onto glacier ice during the waning stages of Wisconsinian deglaciation (about 12 ka BP) may have resulted in dissipation of much impact energy into the ice, resulting in the present morphology of the BCS.

  13. Post trauma abdominal cocoon

    PubMed Central

    Kaur, Supreet; Doley, Rudra Prasad; Chabbhra, Mohinish; Kapoor, Rajeev; Wig, Jaidev

    2014-01-01

    Abdominal cocoon or sclerosing peritonitis refers to a rare cause of intestinal obstruction due to formation of a membrane encasing the bowel. We report a case of abdominal cocoon post blunt trauma abdomen. The patient presented with a history of subacute intestinal obstruction and a mobile abdomen lump. Abdominal cocoon was diagnosed on computed tomography. He underwent adhesiolysis with excision of membrane. PMID:25590647

  14. Renal Artery Embolization Controls Intractable Pain in a Patient with Polycystic Kidney Disease

    SciTech Connect

    Hahn, Seong Tai; Park, Seog Hee; Lee, Jae Mun; Kim, Choon-Yul [Department of Radiology, St. Mary's Hospital, Catholic Medical Center, Catholic University of Korea, 62, Youido-dong, Yongdungpo-gu, Seoul, 150-010 (Korea, Republic of); Chang, Yoon Sik [Department of Internal Medicine, St. Mary's Hospital, Catholic Medical Center, Catholic University of Korea, 62, Youido-dong, Yongdungpo-gu, Seoul, 150-010, Korea (Korea, Republic of)

    1999-09-15

    A 65-year-old man with adult polycystic kidney disease (APKD) and chronic renal failure suffered from intractable abdominal pain and distension for 2 weeks. Meperidine infusion did not alleviate his pain. However, pain and abdominal distension were successfully controlled by embolization of both renal arteries.

  15. Presentation and management of chronic pain.

    PubMed

    Rajapakse, Dilini; Liossi, Christina; Howard, Richard F

    2014-05-01

    Chronic pain is an important clinical problem affecting significant numbers of children and their families. The severity and impact of chronic pain on everyday function is shaped by the complex interaction of biological, psychological and social factors that determine the experience of pain for each individual, rather than a straightforward reflection of the severity of disease or extent of tissue damage. In this article we present the research findings that strongly support a biopsychosocial concept of chronic pain, describe the current best evidence for management strategies and suggest a common general pathway for all types of chronic pain. The principles of management of some of the most important or frequently encountered chronic pain problems in paediatric practice; neuropathic pain, complex regional pain syndrome (CRPS), musculoskeletal pain, abdominal pain and headache are also described. PMID:24554056

  16. Minimal Invasive Treatment of Abdominal Multiorgan Echinococcosis

    PubMed Central

    Tomu?, Claudiu; Zaharie, Florin; Mocan, Lucian; Barto?, Dana; Zaharie, Roxana; Iancu, Cornel; Nadim, Al Hajjar

    2013-01-01

    Hydatid disease is a severe zoonosis, exerting a high economic and social impact through its numerous complications, leading to disabilities, even death. Because of technical developments, especially the increasing experience of surgeons, laparoscopic surgery has been extended so that it can be successfully applied to abdominal hydatid cysts. We present the case of a 16-year-old patient who came to our clinic for upper abdominal pain. The abdominal ultrasonography and computed tomography (CT) showed 2 cyst-like tumors, with hydatid features: one affecting the eighth liver segment and the other located at the upper pole of the spleen. We performed the surgical intervention using a laparoscopic approach, with an uneventful postoperative follow-up and the patient was discharged home on postoperative day 4. The postoperative images at 6 and 12 months showed a decrease in size of the remnant cystic cavities. PMID:23438278

  17. Delayed rupture of gallbladder following blunt abdominal trauma.

    PubMed

    Mohanty, Debajyoti; Agarwal, Himanshu; Aggarwal, Krittika; Garg, Pankaj Kumar

    2014-09-01

    A 29-year-old gentleman presented to surgery emergency with severe upper abdominal pain and vomiting. He reported to had been hit in his abdomen by a ball during a cricket match. Computerized tomogram of the abdomen revealed hematoma within the gallbladder lumen, laceration of segment six of liver, and hemoperitoneum. The patient did not agree for laparotomy advised to him, and so, managed conservatively. The patient reported back to us with high grade fever, jaundice, and painful abdominal distension after seven days of discharge from the hospital. His abdominal examination showed features of generalized peritonitis. Surgical abdominal exploration revealed a single perforation in the fundus of gallbladder with frozen calot'striangle. Subtotal cholecystectomy was done. Histopathology of excised gallbladder revealed xanthogranulomatous inflammation. The present case report highlights that early exploration and cholecystectomy should be considered in patients with gallbladder injury to obviate the risk of delayed perforation. PMID:25705289

  18. Fallopian tube prolapse after abdominal hysterectomy.

    PubMed

    Noor, Shehla; Halimi, Mussarat; Faiz, Nasreen Ruby; Sadaf, Farhadia; Akhtar, Perveen; Zahoor, Shafaq

    2004-01-01

    A 38 year old lady who had total abdominal hysterectomy, for chronic pelvic pain, presented with profuse vaginal discharge per vaginum along with a cystic pelvic mass of 10 week size. There was a polypoidal fleshy growth present in the vault. It was diagnosed to be a fallopian tube on histopathology. Patient was treated with bilateral salpingo-ophorectomy through an open laparotomy. PMID:15455626

  19. Flank pain

    MedlinePLUS

    Pain - side; Side pain ... Flank pain can be a sign of a kidney problem. However, since many organs are in this area, other causes are possible. If you have flank pain and fever , chills, blood in the urine, or ...

  20. Abdominal Decompression in Children

    PubMed Central

    Ejike, J. Chiaka; Mathur, Mudit

    2012-01-01

    Abdominal compartment syndrome (ACS) increases the risk for mortality in critically ill children. It occurs in association with a wide variety of medical and surgical diagnoses. Management of ACS involves recognizing the development of intra-abdominal hypertension (IAH) by intra-abdominal pressure (IAP) monitoring, treating the underlying cause, and preventing progression to ACS by lowering IAP. When ACS is already present, supporting dysfunctional organs and decreasing IAP to prevent new organ involvement become an additional focus of therapy. Medical management strategies to achieve these goals should be employed but when medical management fails, timely abdominal decompression is essential to reduce the risk of mortality. A literature review was performed to understand the role and outcomes of abdominal decompression among children with ACS. Abdominal decompression appears to have a positive effect on patient survival. However, prospective randomized studies are needed to fully understand the indications and impact of these therapies on survival in children. PMID:22482041

  1. Sonographic appearances of the abdominal manifestations of hereditary angioedema.

    PubMed

    Dinkel, H P; Maroske, J; Schrod, L

    2001-04-01

    Hereditary angioedema (HAE) is the autosomal dominant deficiency of C1-esterase inhibitor. There have hitherto been no reports on the US appearances of HAE. The unique case of a 12-year-old girl with recurrent abdominal pain is reported, in whom HAE was diagnosed by US and family history of paroxysmal dyspnoea, cutaneous swelling and attacks of abdominal pain. Pertinent US features were intestinal oedema and ascites. Sonographic evidence of intestinal swelling was only seen on the initial day of an episode of abdominal pain. Oedema, as demonstrated by MRI the following day, regressed rapidly, whereas ascites persisted for at least 3 days. It is therefore important to perform imaging in the acute phase to demonstrate the massive intestinal oedema, which is characteristic for the disease. PMID:11321752

  2. [Thoracic and abdominal wounds].

    PubMed

    Martinod, E; Lang-Lazdunski, L; Liard, O; Jancovici, R

    1997-05-01

    Thoracic and abdominal wounds are characterized by their diversity, their possible danger and the necessity of a successful diagnosis and therapy strategy. Management of thoracic wounds and indications of surgical treatment are conditioned by airway and hemodynamic states, paraclinical exams and chest drainage. The approach of abdominal wounds is based upon their possible penetrating character. Surgical indications, even if very discussed, are still wider. Thoraco-abdominal wounds could concern the diaphragm and are remarkable for their surgical strategy. PMID:9208685

  3. Primary abdominal lymphangioleiomyomatosis: report of a case.

    PubMed

    Ding, Yuan; Yan, Sheng; Tian, Yang; Li, Zhiwei; Pan, Jun; Zhang, Qiyi; Wang, Yan; Zheng, Shusen

    2015-12-01

    Lymphangioleiomyomatosis is an uncommon progressive disease characterized by hamartomatous smooth muscle proliferation of the airways within the lungs as well as the lymph nodes, lymphatics, and blood vessels of the lungs, mediastinum, and abdomen. The most common manifestations of lymphangioleiomyomatosis are pulmonary symptoms. Primary abdominal lymphangioleiomyomatosis without any pathological changes in the respiratory system is extremely unusual. We report a case of primary abdominal lymphangioleiomyomatosis located between the left hepatic and gastric antrum of a 29-year-old woman. The patient had no typical symptoms of lymphangioleiomyomatosis (dyspnea, pneumothorax) or abdominal pain. All physical examination findings were normal. Laboratory test results, including routine blood examination, liver and kidney function, tumor markers, blood coagulation function, and urine and stool examinations, were all normal. She found abdominal cyst in an annual medical examination by ultrasonography and confirmed by computed tomography. For a clear diagnosis, a laparoscopic abdominal mass resection was performed. The postoperative pathohistological examination findings allowed for the definitive diagnosis. This case report may advance the understanding of primary peritoneal lymphatic leiomyoma and reduce the number of mistakenly diagnosed patients. PMID:25778080

  4. Primary abdominal lymphangioleiomyomatosis: report of a case.

    PubMed

    Ding, Yuan; Yan, Sheng; Tian, Yang; Li, Zhiwei; Pan, Jun; Zhang, Qiyi; Wang, Yan; Zheng, Shusen

    2015-01-01

    Lymphangioleiomyomatosis is an uncommon progressive disease characterized by hamartomatous smooth muscle proliferation of the airways within the lungs as well as the lymph nodes, lymphatics, and blood vessels of the lungs, mediastinum, and abdomen. The most common manifestations of lymphangioleiomyomatosis are pulmonary symptoms. Primary abdominal lymphangioleiomyomatosis without any pathological changes in the respiratory system is extremely unusual. We report a case of primary abdominal lymphangioleiomyomatosis located between the left hepatic and gastric antrum of a 29-year-old woman. The patient had no typical symptoms of lymphangioleiomyomatosis (dyspnea, pneumothorax) or abdominal pain. All physical examination findings were normal. Laboratory test results, including routine blood examination, liver and kidney function, tumor markers, blood coagulation function, and urine and stool examinations, were all normal. She found abdominal cyst in an annual medical examination by ultrasonography and confirmed by computed tomography. For a clear diagnosis, a laparoscopic abdominal mass resection was performed. The postoperative pathohistological examination findings allowed for the definitive diagnosis. This case report may advance the understanding of primary peritoneal lymphatic leiomyoma and reduce the number of mistakenly diagnosed patients. PMID:25888993

  5. UNEXPLAINED VISCERAL PAIN IN CHILDREN: PATHOPHYSIOLOGY, CLINICAL FEATURES AND MANAGEMENT

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Many children experience recurrent episodes of abdominal pain, but it is unclear why this occurs. This article reviews our present understanding of this common condition and how it sometimes can relate to diet, inherent pain sensing ability, and the influence of how the parents perceive pain....

  6. UPJ obstruction

    MedlinePLUS

    ... they may include: Back or flank pain Bloody urine (hematuria) Lump in the abdomen (abdominal mass) Kidney infection Poor growth in infants (failure to thrive) Urinary tract infection, usually with fever Vomiting

  7. Gastrointestinal (GI) permeability correlates with trait anxiety and urinary norepinephrine/creatinine (CR)ratio in children with functional abdominal pain (FAP)and irritable bowel syndrome (IBS) but not in controls

    Technology Transfer Automated Retrieval System (TEKTRAN)

    FAP and IBS affect 10–15% of school age children and bear many similarities to irritable bowel syndrome (IBS) in adults (e.g., functional pain, visceral hyperalgesia). Animal models of IBS have suggested a relationship between neonatal stress/anxiety and increased GI permeability later in life. We h...

  8. Complementary and alternative medicine (CAM) use in children with functional abdominal pain (FAP) and irritable bowel syndrome (IBS) differs in tertiary vs. primary care and is related to mother's view of child disability

    Technology Transfer Automated Retrieval System (TEKTRAN)

    We sought to determine if CAM use was greater in children in tertiary vs. primary care, and whether child or parent report of pain characteristics, and/or child and mother's psychological characteristics differed between those who did/did not use CAM. We identified children 7-10 years of age with FA...

  9. Cancer pain

    SciTech Connect

    Swerdlow, M.; Ventafridda, V.

    1987-01-01

    This book contains 13 chapters. Some of the chapter titles are: Importance of the Problem; Neurophysiology and Biochemistry of Pain; Assessment of Pain in Patients with Cancer; Drug Therapy; Chemotherapy and Radiotherapy for Cancer Pain; Sympton Control as it Relates to Pain Control; and Palliative Surgery in Cancer Pain Treatment.

  10. Is all pain is treated equally? A multicenter evaluation of acute pain care by age.

    PubMed

    Hwang, Ula; Belland, Laura K; Handel, Daniel A; Yadav, Kabir; Heard, Kennon; Rivera-Reyes, Laura; Eisenberg, Amanda; Noble, Matthew J; Mekala, Sudha; Valley, Morgan; Winkel, Gary; Todd, Knox H; Morrison, R Sean

    2014-12-01

    Pain is highly prevalent in health care settings; however, disparities continue to exist in pain care treatment. Few studies have investigated if differences exist based on patient-related characteristics associated with aging. The objective of this study was to determine if there are differences in acute pain care for older vs younger patients. This was a multicenter, retrospective, cross-sectional observation study of 5 emergency departments across the United States evaluating the 2 most commonly presenting pain conditions for older adults, abdominal and fracture pain. Multivariable adjusted hierarchical modeling was completed. A total of 6,948 visits were reviewed. Older (? 65 years) and oldest (? 85 years) were less likely to receive analgesics compared to younger patients (<65 years), yet older patients had greater reductions in final pain scores. When evaluating pain treatment and final pain scores, differences appeared to be based on type of pain. Older patients with abdominal pain were less likely to receive pain medications, while older patients with fracture were more likely to receive analgesics and opioids compared to younger patients. Differences in pain care for older patients appear to be driven by the type of presenting pain. PMID:25244947

  11. Abdominal apoplexy: A case study of the spontaneous rupture of the gastroepiploic artery

    Microsoft Academic Search

    Mehul Jadav; Yvan Ducheine; Larry Carter; Theresa McWhite; James Hardy

    2004-01-01

    This is a case report of abdominal apoplexy (AA) or spontaneous rupture of a visceral vessel, without associated aneurysmal dilation of the vessel. Spontaneous rupture of the left gastroepiploic artery (LGEA) resulting in a hemoperitoneum is discussed. The clinical presentation of left lower quadrant abdominal pain, along with the histologic findings of medial degeneration of the LGEA, makes this case

  12. [Ultrasound for abdominal lymphadenopathy].

    PubMed

    Dietrich, C F; Hocke, M; Jenssen, C

    2013-05-01

    This CME-review is about the clinical importance of the abdominal lymph node diagnostic with special attention to various ultrasound techniques. This includes innovative techniques like contrast enhanced ultrasound and elastography. The clinical importance of ultrasound in relation to cross sectional imaging will be the target of the article as well as anatomic- topographic aspects. The article deals as well with endosonographic techniques because of the upmost importance of the technique for diagnosing mediastinal and abdominal lymphnode swellings. In conclusion of the article different clinical scenarios and clinical algorithms are presented to help the reader to diagnose abdominal lymphadenopathy correctly in an efficient way. PMID:23633280

  13. Abdominal compartment syndrome

    Microsoft Academic Search

    Jeffrey Bailey; Marc J Shapiro

    2000-01-01

    Intra-abdominal hypertension (IAH) associated with organ dysfunction\\u0009\\u0009\\u0009 defines the abdominal compartment syndrome (ACS). Elevated intra-abdominal\\u0009\\u0009\\u0009 pressure (IAP) adversely impacts pulmonary, cardiovascular, renal, splanchnic,\\u0009\\u0009\\u0009 musculoskeletal\\/integumentary, and central nervous system physiology. The\\u0009\\u0009\\u0009 combination of IAH and disordered physiology results in a clinical syndrome\\u0009\\u0009\\u0009 with significant morbidity and mortality. The onset of the ACS requires prompt\\u0009\\u0009\\u0009 recognition and appropriately timed and staged intervention

  14. Foetal pain?

    PubMed

    Derbyshire, Stuart W G

    2010-10-01

    The majority of commentary on foetal pain has looked at the maturation of neural pathways to decide a lower age limit for foetal pain. This approach is sensible because there must be a minimal necessary neural development that makes pain possible. Very broadly, it is generally agreed that the minimal necessary neural pathways for pain are in place by 24 weeks gestation. Arguments remain, however, as to the possibility of foetal pain before or after 24 weeks. Some argue that the foetus can feel pain earlier than 24 weeks because pain can be supported by subcortical structures. Others argue that the foetus cannot feel pain at any stage because it is maintained in a state of sedation in the womb and lacks further neural and conceptual development necessary for pain. Much of this argument rests on the definition of terms such as 'wakefulness' and 'pain'. If a behavioural and neural reaction to a noxious stimulus is considered sufficient for pain, then pain is possible from 24 weeks and probably much earlier. If a conceptual subjectivity is considered necessary for pain, however, then pain is not possible at any gestational age. Regardless of how pain is defined, it is clear that pain for conceptual beings is qualitatively different than pain for non-conceptual beings. It is therefore a mistake to draw an equivalence between foetal pain and pain in the older infant or adult. PMID:20356798

  15. Pain (PDQ)

    MedlinePLUS

    ... cancer treatment ends. Pain control can improve your quality of life. Pain can be controlled in most patients with ... in most patients. Pain control can improve your quality of life all through your cancer treatment and after it ...

  16. Elbow pain

    MedlinePLUS

    Pain - elbow ... Elbow pain can be caused by a variety of problems. A common cause in adults is tendinitis , an inflammation ... a partial dislocation ). Other common causes of elbow pain are: Bursitis -- inflammation of a fluid-filled cushion ...

  17. Heel pain

    MedlinePLUS

    Pain - heel ... Heel pain is most often the result of overuse. Rarely, it may be caused by an injury. Your heel ... on the heel Conditions that may cause heel pain include: When the tendon that connects the back ...

  18. Neck Pain

    MedlinePLUS

    ... Pregnancy and Rheumatic Disease Sex and Arthritis Neck Pain PRINT Download PDF Description Saying, “It’s a pain ... requires expensive or uncomfortable tests. What is neck pain? Acute strain may occur after sleeping in an ...

  19. Wrist pain

    MedlinePLUS

    ... back. Over-the-counter pain medications, such as ibuprofen or naproxen, can relieve pain and swelling. Various, ... Take over-the-counter pain medication, such as ibuprofen or acetaminophen. Wear a splint for several days. ...

  20. Pain Relievers

    MedlinePLUS

    Pain relievers are medicines that reduce or relieve headaches, sore muscles, arthritis, or other aches and pains. There ... also have a slightly different response to a pain reliever. Over-the-counter (OTC) medicines are good for ...

  1. Normal Abdominal CT

    NSDL National Science Digital Library

    Shaffer, Kitt

    Set of normal abdominal CT images with various important anatomic structures outlined, for cine viewing to gain a 3D view of the structure and its relationship to adjacent organs.Annotated: trueDisease diagnosis: Normal

  2. Abdominal ultrasound (image)

    MedlinePLUS

    Abdominal ultrasound is a scanning technique used to image the interior of the abdomen. Like the X-ray, MRI, ... it has its place as a diagnostic tool. Ultrasound scans use high frequency sound waves to produce ...

  3. Pain Medication Requirements After Sacropexy and Combination Interventions

    PubMed Central

    Schiermeier, Sven; Hatzmann, Wolfgang; Soltész, Stefan; Spüntrup, Carolin; Anapolski, Michael

    2014-01-01

    Background and Objectives: Laparoscopic surgery is associated with reduced morbidity, and postoperative pain is reduced. The aim of this study was to assess postoperative pain intensity, analgesic requirements, and the influence of cofactors after laparoscopic sacral colpopexy. Methods: The study assessed 287 patients treated with laparoscopic sacropexy for genital prolapse with a Pelvic Organ Prolapse Quantification grade >1. Patients were asked to evaluate their pain postoperatively using a 4-point verbal pain rating scale. In addition, medical records were analyzed regarding the requirement for analgesic medication. Results: Patients distinguished between abdominal pain and shoulder pain after laparoscopy. Abdominal pain reached maximum severity on day 1 and showed a good response to nonsteroidal antiphlogistics, whereas shoulder pain was rarely found (6.27%). Of the patients, 38% required no pain treatment or required 1 dose at most. The need for pain medication reached its climax on day 1 and decreased during the 5 following days. Non-opioid analgesics provided a sufficient therapeutic effect. Conclusion: Laparoscopic sacropexy is associated with a moderate degree of postoperative pain. Non-opioid analgesics should be preferred as first-line therapy. The typical shoulder-tip pain showed only a low prevalence in our study group. From our point of view, the low rate of shoulder-tip pain corresponded with the low intra-abdominal carbon dioxide pressure. PMID:25392656

  4. Laparoscopic Management of an Abdominal Pregnancy

    PubMed Central

    2014-01-01

    Background. Ectopic pregnancy is one of the leading causes of significant maternal morbidity and mortality. Abdominal surgeries increase the risk of postoperative adhesions. We here present a case of omental ectopic pregnancy in a patient with a prior history of cesarean section. Case. A 20-year-old female presented with a two-day history of crampy lower abdominal pain. Patient was hemodynamically stable with a beta HCG of 1057?mI/mL. Transvaginal ultrasound did not show an intrauterine pregnancy but revealed an ill-defined mass in the midline pelvis extending to the right of the midline. Diagnostic laparoscopy revealed large clots in the pelvis with normal uterus and adnexa. Intra-abdominal survey revealed an omental adhesion close to the right adnexa with a hematoma. Partial omentectomy was completed and the portion of the omentum with the hematoma was sent to pathology for confirmation. Final pathology confirmed the presence of chorionic villi consistent with products of conception. Conclusion. Omental ectopic pregnancy is a rare diagnosis and often missed. We recommend careful intra-abdominal survey for an ectopic pregnancy in the presence of hemoperitoneum with normal uterus and adnexa. This can be safely achieved using laparoscopy in early gestational ages when the patient is hemodynamically stable. PMID:25478262

  5. Abdominal Compartment Syndrome Secondary to Chronic Constipation

    PubMed Central

    Flageole, Helene; Ouahed, Jodie; Walton, J. Mark; Yousef, Yasmin

    2011-01-01

    Abdominal compartment syndrome (ACS) is defined as an elevated intraabdominal pressure with evidence of organ dysfunction. The majority of published reports of ACS are in neonates with abdominal wall defects and in adults following trauma or burns, but it is poorly described in children. We describe the unusual presentation of an 11-year-old boy with a long history of chronic constipation who developed acute ACS requiring resuscitative measures and emergent disimpaction. He presented with a 2-week history of increasing abdominal pain, nausea, diminished appetite and longstanding encopresis. On exam, he was emaciated with a massively distended abdomen with a palpable fecaloma. Abdominal XR confirmed these findings. Within 24 hours of presentation, he became tachycardic and oliguric with orthostatic hypotension. Following two enemas, he acutely deteriorated with severe hypotension, marked tachycardia, acute respiratory distress, and a declining mental status. Endotracheal intubation, fluid boluses, and vasopressors were commenced, followed by emergent surgical fecal disimpaction. This resulted in rapid improvement in vital signs. He has been thoroughly investigated and no other condition apart from functional constipation has been identified. Although ACS secondary to constipation is extremely unusual, this case illustrates the need to actively treat constipation and what can happen if it is not. PMID:22606517

  6. Relief of postoperative pain with jaw relaxation, music and their combination

    Microsoft Academic Search

    Marion Good; Michael Stanton-Hicks; Jeffrey A. Grass; Gene Cranston Anderson; Charles Choi; Laree J Schoolmeesters; Ali Salman

    1999-01-01

    The aim of this randomized controlled trial was to determine the effect of jaw relaxation, music and the combination of relaxation and music on postoperative pain after major abdominal surgery during ambulation and rest on postoperative days 1 and 2. Opioid medication provided for pain, following abdominal surgery, does not always give sufficient relief and can cause undesired side effects.

  7. Visceral pain: spinal afferents, enteric mast cells, enteric nervous system and stress.

    PubMed

    Wood, Jackie D

    2011-01-01

    This review aims to examine current basic and clinical concepts, the results of which are expanding our understanding of visceral hypersensitivity and functional abdominal pain of intestinal origin in relation to the enteric nervous system (ENS), spinal sensory neurons and enteric mast cells. Advances in this sphere are translating to improved insight into chronic functional abdominal and pelvic pain syndromes in general. PMID:21548869

  8. Pelvic Pain

    MedlinePLUS

    Pelvic pain occurs mostly in the lower abdomen area. The pain might be steady, or it might come and go. If the pain is severe, it might get in the way ... re a woman, you might feel a dull pain during your period. It could also happen during ...

  9. A case of abdominal apoplexy because of the rupture of the short gastric vessel.

    PubMed

    Osunkunle, Olaoluwakitan A; Al-Shoek, Ihsan

    2015-01-01

    Abdominal apoplexy or idiopathic spontaneous intraperitoneal haemorrhage is defined as the presence of free blood within the peritoneal cavity. Non-traumatic and non-iatrogenic causes may cause abdominal apoplexy. It has a variable clinical presentation, with abdominal pain being an early and non-specific symptom. We report a rare case of a 23-year-old male with abdominal apoplexy because of rupture of the short gastric artery. He presented to our department with abdominal pain. Later, he developed signs of shock, and was found to have haemoperitoneum on laparotomy. We ligated the short gastric artery, which was the bleeding source, and he had an uneventful postoperative course. We also review the literature on existing cases of short gastric vessel rupture. PMID:25759171

  10. A case of abdominal apoplexy because of the rupture of the short gastric vessel

    PubMed Central

    Osunkunle, Olaoluwakitan A.; Al-Shoek, Ihsan

    2015-01-01

    Abdominal apoplexy or idiopathic spontaneous intraperitoneal haemorrhage is defined as the presence of free blood within the peritoneal cavity. Non-traumatic and non-iatrogenic causes may cause abdominal apoplexy. It has a variable clinical presentation, with abdominal pain being an early and non-specific symptom. We report a rare case of a 23-year-old male with abdominal apoplexy because of rupture of the short gastric artery. He presented to our department with abdominal pain. Later, he developed signs of shock, and was found to have haemoperitoneum on laparotomy. We ligated the short gastric artery, which was the bleeding source, and he had an uneventful postoperative course. We also review the literature on existing cases of short gastric vessel rupture. PMID:25759171

  11. Abdominal Aortic Aneurysm (AAA) Screening

    MedlinePLUS

    ... covered? Search Medicare.gov for covered items Abdominal aortic aneurysm screening How often is it covered? Medicare Part B (Medical Insurance) covers a one-time abdominal aortic aneurysm ultrasound. You must get a referral for it ...

  12. Screening for Abdominal Aortic Aneurysm

    MedlinePLUS

    Understanding Task Force Recommendations Screening for Abdominal Aortic Aneurysm The U.S. Preventive Services Task Force (Task Force) has issued a final recommendation statement on Screening for Abdominal Aortic Aneurysm. This final recommendation ...

  13. Laparoscopic total abdominal colectomy

    Microsoft Academic Search

    Steven D. Wexner; Olaf B. Johansen; Juan J. Nogueras; David G. Jagelman

    1992-01-01

    The aim of this study was to prospectively assess the impact of laparoscopy upon the outcome of total abdominal colectomy (TAC). Specifically, patients underwent standard laparotomy with TAC and ileoproctostomy (TAC + IP), TAC and ileoanal reservoir (TAC + IAR), laparoscopically assisted TAC + IP (L-TAC + IP), or laparoscopically assisted TAC + IAR (L-TAC + IAR). Parameters studied included

  14. Enhanced surveillance during a large outbreak of bloody diarrhoea and haemolytic uraemic syndrome caused by Shiga toxin/verotoxin-producing Escherichia coli in Germany, May to June 2011.

    PubMed

    Wadl, M; Rieck, T; Nachtnebel, M; Greutélaers, B; an der Heiden, M; Altmann, D; Hellenbrand, W; Faber, M; Frank, C; Schweickert, B; Krause, G; Benzler, J; Eckmanns, T

    2011-01-01

    Germany has a well established broad statutory surveillance system for infectious diseases. In the context of the current outbreak of bloody diarrhoea and haemolytic uraemic syndrome caused by Shiga toxin/ verotoxin-producing Escherichia coli in Germany it became clear that the provisions of the routine surveillance system were not sufficient for an adequate response. This article describes the timeline and concepts of the enhanced surveillance implemented during this public health emergency. PMID:21699769

  15. Pain Assessment

    MedlinePLUS

    ... as a result of the pain, and the nature of other medical and psychiatric problems, should be ... information helps the health care provider understand the nature of the pain or the potential benefits of ...

  16. Finger pain

    MedlinePLUS

    Pain - finger ... Nearly everyone has had finger pain at some time. You may have: Tenderness Burning Stiffness Numbness Tingling Coldness Swelling Change in skin color Redness Many conditions, such ...

  17. Orofacial Pain

    MedlinePLUS

    ... Neck, shoulder or back pain Dizziness ?xml:namespace> Sleep disorders ; If you have gone through treatment and still experience orofacial pain, you may have a sleep disorder, such as bruxism, or a sleep-related breathing ...

  18. Knee pain

    MedlinePLUS

    ... avoid activities that aggravate your pain, especially weight bearing activities. Apply ice. First, apply it every hour ... knee You have severe pain, even when not bearing weight Your knee buckles, clicks, or locks Your ...

  19. Neck Pain

    MedlinePLUS

    ... over-the counter medicine, such as acetaminophen or ibuprofen, to relieve pain, and apply heat to the ... an injury. Use anti-inflammatory medicines, such as ibuprofen and aspirin, to relieve pain and discomfort, and ...

  20. Back Pain

    MedlinePLUS

    ... my aching back!", you are not alone. Back pain is one of the most common medical problems, affecting 8 out of 10 people at some point during their lives. Back pain can range from a dull, constant ache to ...

  1. Chronic Pain

    MedlinePLUS

    ... 2002. Reflex Sympathetic Dystrophy/ Complex Regional Pain Syndromes (CRPS): State-of-the-Science A workshop on Reflex Sympathetic Dystrophy/ Complex Regional Pain Syndromes (CRPS): State-of-the-Science, December 15, 2001. Publicaciones ...

  2. Pain management in polycystic kidney disease.

    PubMed

    Bajwa, Z H; Gupta, S; Warfield, C A; Steinman, T I

    2001-11-01

    Pain is a common complaint in patients with autosomal-dominant polycystic kidney disease, and a systematic approach is needed to differentiate the etiology of the pain and define an approach to management. A thorough history is the best clue to the multifactorial causes of the pain, superimposed upon an understanding of the complex innervation network that supplies the kidneys. The appropriate use of diagnostic radiology (especially MRI) will assist in differentiating the mechanical low back pain caused by cyst enlargement, cyst rupture and cyst infection. Also, the increased incidence of uric acid nephrolithiasis as a factor in producing renal colic must be considered when evaluating acute pain in the population at risk. MRI is not a good technique to detect renal calculi, a frequent cause of pain in polycystic kidney disease. If stone disease is a possibility, then abdominal CT scan and/or ultrasound should be the method of radiologic investigation. Pain management is generally not approached in a systematic way in clinical practice because most physicians lack training in the principles of pain management. The first impulse to give narcotics for pain relief must be avoided. Since chronic pain cannot be "cured," an approach must include techniques that allow the patient to adapt to chronic pain so as to limit interference with their life style. A detailed stepwise approach for acute and chronic pain strategies for the patient with autosomal dominant polycystic kidney disease is outlined. PMID:11703580

  3. Chronic pain.

    PubMed

    2015-03-18

    Essential facts Chronic pain is pain that persists or recurs for more than three months. It may be related to a condition, or may be pain from an injury or operation that continues after healing would usually take place. According to guidance from the Scottish Intercollegiate Guidelines Network (SIGN), around 18 per cent of Europe's population are currently affected by moderate to severe chronic pain. It has a considerable effect on quality of life, and can cause significant suffering and disability. PMID:25783253

  4. Chronic Pain

    Microsoft Academic Search

    Malcolm H. Johnson

    The primary purposes of acute pain and the reason it is noxious are to interrupt ongoing activity in order to warn the sufferer of tissue damage, to discourage movement that might exacerbate injury or prevent healing, and to teach the organism to avoid the pain-producing circumstances. Therefore, it is no wonder that when pain persists to become chronic, many sufferers

  5. Face pain

    MedlinePLUS

    Face pain may be dull and throbbing or an intense, stabbing discomfort in the face or forehead. It can occur in one or ... Pain that starts in the face may be caused by a nerve problem, ... Face pain may also begin other places in the body. Abscessed ...

  6. Pain management in patients with inflammatory bowel disease: insights for the clinician

    PubMed Central

    Srinath, Arvind Iyengar; Walter, Chelsea; Newara, Melissa C.

    2012-01-01

    Abdominal pain is a common symptom in patients with inflammatory bowel disease (IBD) and has a profound negative impact on patients’ lives. There are growing data suggesting that pain is variably related to the degree of active inflammation. Given the multifactorial etiologies underlying the pain, the treatment of abdominal pain in the IBD population is best accomplished by individualized plans. This review covers four clinically relevant categories of abdominal pain in patients with IBD, namely, inflammation, surgical complications, bacterial overgrowth, and neurobiological processes and how pain management can be addressed in each of these cases. The role of genetic factors, psychological factors, and psychosocial stress in pain perception and treatment will also be addressed. Lastly, psychosocial, pharmacological, and procedural pain management techniques will be discussed. An extensive review of the existing literature reveals a paucity of data regarding pain management specific to IBD. In addition, there is growing consensus suggesting a spectrum between IBD and irritable bowel syndrome (IBS) symptoms. Thus, this review for adult and pediatric clinicians also incorporates the literature for the treatment of functional abdominal pain and the clinical consensus from IBD and IBS experts on pharmacological, behavioral, and procedural methods to treat abdominal pain in this population. PMID:22973418

  7. A new paradigm in chronic bladder pain.

    PubMed

    Wesselmann, Ursula

    2014-12-01

    The concept of visceral pain has moved from organ-centered disease to a conceptualization based on pathophysiological mechanisms, integrating psychosocial and sexual dimensions. The terms painful bladder syndrome and bladder pain syndrome have been coined to include all patients with bladder pain. There is substantial overlap between IC/BPS and other pelvic/abdominal pain syndromes IC/BPS is likely to be underdiagnosed and undertreated in both men and women IC/BPS requires a multidisciplinary team approach toward management. This report is adapted from paineurope 2014; Issue 2, ©Haymarket Medical Publications Ltd, and is presented with permission. Paineurope is provided as a service to pain management by Mundipharma International, LTD and is distributed free of charge to healthcare professionals in Europe. Archival issues can be accessed via the website: http://www.paineurope.com at which European health professionals can register online to receive copies of the quarterly publication. PMID:25348226

  8. Abdominal sensitivity in the first year of life: comparison of infants with and without prenatally diagnosed unilateral hydronephrosis

    Microsoft Academic Search

    K. A Andrews; D Desai; H. K Dhillon; D. T Wilcox; M Fitzgerald

    2002-01-01

    There are few studies on visceral pain in infants, despite its clinical importance. We have used the abdominal skin reflex (ASR) to measure changes in abdominal sensitivity in the presence of visceral pathology in infants. The reflex was elicited by applying calibrated von Frey hairs to each side of the abdomen and the mechanical threshold and the degree of reflex

  9. Back Pain

    MedlinePLUS

    ... being overweight, poor physical conditioning, smoking, whole body vibration, and improper lifting technique and body mechanics, including ... core body strength (back and abdominal muscles). • Decrease vibrations by installing air cushions or upgrade seat to ...

  10. Drug Management of Visceral Pain: Concepts from Basic Research

    PubMed Central

    Davis, Mellar P.

    2012-01-01

    Visceral pain is experienced by 40% of the population, and 28% of cancer patients suffer from pain arising from intra- abdominal metastasis or from treatment. Neuroanatomy of visceral nociception and neurotransmitters, receptors, and ion channels that modulate visceral pain are qualitatively or quantitatively different from those that modulate somatic and neuropathic pain. Visceral pain should be recognized as distinct pain phenotype. TRPV1, Na 1.8, and ASIC3 ion channels and peripheral kappa opioid receptors are important mediators of visceral pain. Mu agonists, gabapentinoids, and GABAB agonists reduce pain by binding to central receptors and channels. Combinations of analgesics and adjuvants in animal models have supra-additive antinociception and should be considered in clinical trials. This paper will discuss the neuroanatomy, receptors, ion channels, and neurotransmitters important to visceral pain and provide a basic science rationale for analgesic trials and management. PMID:22619712

  11. Biomarkers in abdominal imaging

    Microsoft Academic Search

    Bernard E. Van Beers; Valérie Vilgrain

    2009-01-01

    Imaging biomarkers are parameters measurable with imaging methods used to detect, stage or grade disease or assess the response\\u000a to treatment. Compared with biochemical or histological markers, imaging biomarkers have the advantage of remaining non-invasive\\u000a and being spatially and temporally resolved. Imaging biomarkers are used in multiple abdominal diseases, including cancer.\\u000a Anatomical imaging biomarkers such as the RECIST criteria are

  12. Abdominal vascular injuries.

    PubMed

    Mullins, R J; Huckfeldt, R; Trunkey, D D

    1996-08-01

    Injuries to major abdominal arteries and veins frequently are associated with exsanguinating hemorrhage and visceral ischemia. Expeditious management is the key to survival and good outcome. Knowledge of anatomic relationships between viscera and vessels forms the basis for directed dissection, optimal exposure, and lasting repair of vessels. Although penetrating mechanism of injury remains the most common cause of these injuries, trauma surgeons must be familiar with patterns of blunt trauma-mediated injury to avoid the devastating consequences of delayed management. PMID:8782475

  13. Abdominal trauma by ostrich

    PubMed Central

    Usurelu, Sergiu; Bettencourt, Vanessa; Melo, Gina

    2015-01-01

    Introduction Ostriches typically avoid humans in the wild, since they correctly assess humans as potential predators, and, if approached, often run away. However, ostriches may turn aggressive rather than run when threatened, especially when cornered, and may also attack when they feel the need to defend their offspring or territories. Presentation of case A 71-year-old male patient presented with intra abdominal injury sustained from being kicked in the abdominal wall by an ostrich. During laparotomy, were found free peritoneal effusion and perforation of the small intestine. Discussion The clinical history and physical examination are extremely important for diagnostic and therapeutic decision making. CT-scan is the most accurate exam for making diagnosis. Surgery is the treatment of choice, and is always indicated when there is injury to the hollow viscera. In general it is possible to suture the defect. Conclusion In cases of blunt abdominal trauma by animals is necessary to have a low threshold of suspicion for acute abdomen. PMID:25685344

  14. Abdominal SPECT imaging

    SciTech Connect

    Van Heertum, R.L.; Brunetti, J.C.; Yudd, A.P.

    1987-07-01

    Over the past several years, abdominal single photon emission computed tomography (SPECT) imaging has evolved from a research tool to an important clinical imaging modality that is helpful in the diagnostic assessment of a wide variety of disorders involving the abdominal viscera. Although liver-spleen imaging is the most popular of the abdominal SPECT procedures, blood pool imaging is becoming much more widely utilized for the evaluation of cavernous hemangiomas of the liver as well as other vascular abnormalities in the abdomen. Adjunctive indium leukocyte and gallium SPECT studies are also proving to be of value in the assessment of a variety of infectious and neoplastic diseases. As more experience is acquired in this area, SPECT should become the primary imaging modality for both gallium and indium white blood cells in many institutions. Renal SPECT, on the other hand, has only recently been used as a clinical imaging modality for the assessment of such parameters as renal depth and volume. The exact role of renal SPECT as a clinical tool is, therefore, yet to be determined. 79 references.

  15. Daisaikoto for Menstrual Pain: A Lesson from a Case with Menstrual Pain Successfully Treated with Daisaikoto

    PubMed Central

    Horiba, Yuko; Watanabe, Kenji

    2015-01-01

    Menstrual pain is one of the common symptoms among women. It is estimated that 5–14% of women are sometimes absent from school or work because of pain. Usually gynecologists prescribe analgesics and/or low-dose oral contraceptives. However, such treatment is not always effective and sometimes causes an adverse effect, such as stomach pain or low body temperature. Kampo medicine is one of the choices for the menstrual pain in Japan. Tokishakuyakusan, kamishoyosan, or keishibukuryogan is commonly used for the treatment of menstrual pain. Here we report a case of menstrual pain successfully treated with daisaikoto which is not commonly used for such a case. Twenty-five-year-old woman suffered from severe menstrual pain and stress at company. She also had constipation and abdominal distension. We prescribed daisaikoto extract 7.5?g per day. Not only menstrual pain but also constipation and abdominal distension improved within 6 months. Here we propose that daisaikoto is one of the choices for the treatment of menstrual pain with mental stress.

  16. Death due to isolated jejunal tear following blunt abdominal trauma.

    PubMed

    Hugar, Basappa S; Yajaman, Girishchandra P; Kainoor, Sunilkumar; Shetty, Akshith Raj S

    2014-09-01

    Small intestinal injury following blunt abdominal trauma has been widely reported. Isolated jejunal tear which is caused by blunt abdominal trauma is rare and is most often seen in road traffic accidents. Here, we report a case of isolated jejunal tear in a 24-year-old male truck driver. He was admitted to a tertiary care hospital in a South Indian Metropolitan city with complaints of acute abdominal pain and tiredness following alleged accidental blunt trauma sustained to abdomen due to steering wheel impact. An isolated jejunal tear and adjacent mesenteric contusion and tear were missed by the treating physician even after preliminary investigations, and thus, the conservative management was instituted. The condition deteriorated gradually, and he succumbed to death. The autopsy revealed transverse tear of jejunum almost involving whole of its circumference on the antimesenteric border and peritonitis. Proper use of radio-diagnostic techniques and timely undertaken explorative laparotomy would have saved the life. PMID:24547969

  17. Neuropathic Pain

    PubMed Central

    Costigan, Michael; Scholz, Joachim; Woolf, Clifford J.

    2009-01-01

    Neuropathic pain is triggered by lesions to the somatosensory nervous system that alter its structure and function so that pain occurs spontaneously and responses to noxious and innocuous stimuli are pathologically amplified. The pain is an expression of maladaptive plasticity within the nociceptive system, a series of changes that constitute a neural disease state. Multiple alterations distributed widely across the nervous system contribute to complex pain phenotypes. These alterations include ectopic generation of action potentials, facilitation and disinhibition of synaptic transmission, loss of synaptic connectivity and formation of new synaptic circuits, and neuroimmune interactions. Although neural lesions are necessary, they are not sufficient to generate neuropathic pain; genetic polymorphisms, gender, and age all influence the risk of developing persistent pain. Treatment needs to move from merely suppressing symptoms to a disease-modifying strategy aimed at both preventing maladaptive plasticity and reducing intrinsic risk. PMID:19400724

  18. Chronic pain conditions in women.

    PubMed

    Meisler, J G

    1999-04-01

    There are inconsistent data on the age/sex prevalence pattern of back pain and on chest pain. However, it is possible that for chest pain, the rates are higher in younger women and older men. Neck pain, joint pain, and fibromyalgia all appear to increase with age in both genders, whereas abdominal pain and tension-type headaches decrease with age, and migraine headache and TMD appear to peak in the reproductive years. A concluding example illustrates how epidemiologic data can be used to enhance our understanding of the causes of pain. A higher prevalence in women and a peak prevalence during the reproductive years as seen in TMD suggest that either biologic or psychosocial factors unique to women in this period of life could increase the risk of developing or maintaining this pain. As female reproductive hormones can play a role in migraine, at least for some women, it would be interesting to examine whether hormones play a role in TMD. The situation that occurs when menopause is followed by hormone replacement therapy (HRT) provides a natural experiment similar to a laboratory experiment in which female animals are deprived of the natural sources of hormones and then hormones are replaced exogenously. In women, of course, the decision to receive HRT may be associated with a number of psychosocial variables that might also influence pain. Recognizing these limitations, data from records of a large health maintenance organization were examined to ascertain whether use of estrogen or progestin (or both) in postmenopausal women might be associated with the occurrence of TMD pain and, thus, whether the hormone hypothesis might be worthy of further investigation. More women with TMD than controls used estrogen replacement therapy, and slightly more patients than controls used progestin. The use of estrogen significantly increased the odds of having TMD. Progestin use showed a weaker association, which did not hold up after other factors were controlled. However, the risk of TMD appears to increase with increasing doses of estrogen. A review of the epidemiologic literature indicates that there are definite age and sex differences in the prevalence of many chronic pain conditions. There is little basic information about the source of these differences, such as different onset rates, different probabilities of recurrence, or different durations of pain, or combinations of these in women and men. Nevertheless, a systematic examination of the existing epidemiologic data may be an important step in helping pain researchers to generate hypotheses in the search for a better understanding of chronic pain in both sexes. PMID:10326986

  19. PAIN SCALES (ATTACHMENT A)

    E-print Network

    Oliver, Douglas L.

    PAIN SCALES (ATTACHMENT A) 0-10 NUMERIC PAIN INTENSITY SCALE 0 1 2 3 4 5 6 7 8 9 10 NO PAIN MODERATE WORST PAIN PAIN #12;PAIN SCALES (ATTACHMENT A) FLACC PAIN SCALE The FLACC is a behavioral pain assessment scale for use in non-verbal patients unable to provide numeric reports of pain. SCORING Categories

  20. Bloody or tarry stools

    MedlinePLUS

    ... small intestine Diverticulosis (abnormal pouches in the colon) Hemorrhoids (common cause of bright red blood) Inflammatory bowel ... by your doctor, even if you think that hemorrhoids are causing the blood in your stool. In ...

  1. Prevention of Abdominal Adhesions – Present State and What’s beyond the Horizon?

    Microsoft Academic Search

    B. Tingstedt; K. Isaksson; E. Andersson; R. Andersson

    2007-01-01

    Intra-abdominal adhesions are normally found after most surgical procedures. Many of the adhesions are asymptomatic, but in about 5% they will lead to readmission due to adhesion-related disorders, such as small bowel obstruction, pelvic pain and infertility. This review discusses possible ways to prevent abdominal adhesions and provides an update as comes to where we stand today in research regarding

  2. Multiple abdominal cysts in a patient with Gorlin-Goltz syndrome: a case report.

    PubMed

    Haenen, F; Hubens, G; Creytens, D; Vaneerdeweg, W

    2013-01-01

    A rare case of symptomatic mesenteric cysts in a patient with Gorlin-Goltz syndrome, associated with various neoplasms, is presented. The patient, known with Gorlin-Goltz syndrome, consulted with increasingly severe abdominal pain and large abdominal cysts. At surgery, the cysts were excised and the postoperative course was uneventful. In conclusion, this case reminds clinicians to always maintain a wide differential diagnosis when dealing with patients known with Gorlin-Goltz syndrome. PMID:24941720

  3. Abdominal imaging: An introduction

    SciTech Connect

    Frick, M.P.; Feinberg, S.B.

    1986-01-01

    This nine-chapter book gives an overview of the integrated approach to abdominal imaging. Chapter 1 provides an introduction to the physics used in medical imaging; chapter 2 is on the selection of imaging modalities. These are followed by four chapters that deal, respectively, with plain radiography, computed tomographic scanning, sonography, and nuclear imaging, as applied to the abdomen. Two chapters then cover contrast material-enhanced studies of the gastrointestinal (GI) tract: one focusing on technical considerations; the other, on radiologic study of disease processes. The final chapter is a brief account of different interventional procedures.

  4. Minimally Invasive Abdominal Surgery

    PubMed Central

    Richardson, William S.; Carter, Kristine M.; Fuhrman, George M.; Bolton, John S.; Bowen, John C.

    2000-01-01

    In the last decade, laparoscopy has been the most innovative surgical movement in general surgery. Minimally invasive surgery performed through a few small incisions, laparoscopy is the standard of care for the treatment of gallbladder disease and the gold standard for the treatment of reflux disease. The indications for a laparoscopic approach to abdominal disease continue to increase, and many diseases may be treated with laparoscopic techniques. At Ochsner, laparoscopic techniques have demonstrated better cosmetic results, shorter recovery times, and an earlier return to normal activity compared with open surgery. PMID:21765684

  5. Pain channelopathies

    PubMed Central

    Cregg, Roman; Momin, Aliakmal; Rugiero, Francois; Wood, John N; Zhao, Jing

    2010-01-01

    Pain remains a major clinical challenge, severely afflicting around 6% of the population at any one time. Channelopathies that underlie monogenic human pain syndromes are of great clinical relevance, as cell surface ion channels are tractable drug targets. The recent discovery that loss-of-function mutations in the sodium channel Nav1.7 underlie a recessive pain-free state in otherwise normal people is particularly significant. Deletion of channel-encoding genes in mice has also provided insights into mammalian pain mechanisms. Ion channels expressed by immune system cells (e.g. P2X7) have been shown to play a pivotal role in changing pain thresholds, whilst channels involved in sensory transduction (e.g. TRPV1), the regulation of neuronal excitability (potassium channels), action potential propagation (sodium channels) and neurotransmitter release (calcium channels) have all been shown to be potentially selective analgesic drug targets in some animal pain models. Migraine and visceral pain have also been associated with voltage-gated ion channel mutations. Insights into such channelopathies thus provide us with a number of potential targets to control pain. PMID:20142270

  6. Pain Genes

    Microsoft Academic Search

    Tom Foulkes; John N. Wood

    2008-01-01

    Pain, which afflicts up to 20% of the population at any time, provides both a massive therapeutic challenge and a route to understanding mechanisms in the nervous system. Specialised sensory neurons (nociceptors) signal the existence of tissue damage to the central nervous system (CNS), where pain is represented in a complex matrix involving many CNS structures. Genetic approaches to investigating

  7. Heel Pain

    MedlinePLUS

    ... Resting provides only temporary relief. When you resume walking, particularly after a night's sleep, you may experience a sudden elongation of the fascia band, which stretches and pulls on the heel. As you walk, the heel pain may ... Excessive Pronation: Heel pain sometimes results from excessive ...

  8. Pain frequency moderates the relationship between pain catastrophizing and pain

    PubMed Central

    Kjøgx, Heidi; Zachariae, Robert; Pfeiffer-Jensen, Mogens; Kasch, Helge; Svensson, Peter; Jensen, Troels S.; Vase, Lene

    2014-01-01

    Background: Pain frequency has been shown to influence sensitization, psychological distress, and pain modulation. The present study examined if pain frequency moderates the relationship between pain catastrophizing and pain. Method: A non-clinical (247 students) and a clinical (223 pain patients) sample completed the Danish versions of the Pain Catastrophizing Scale (PCS), Beck Depression Inventory, and the State Trait Anxiety Inventory and rated pain intensity, unpleasantness and frequency. Results: In both samples, high pain frequency was found to moderate the association between pain catastrophizing and pain intensity, whereas low pain frequency did not. The psychometric properties and the factor structure of the Danish version of the PCS were confirmed. Conclusions: This is the first study to validate the Danish version of the PCS and to show that pain frequency moderates the relationship between pain catastrophizing and reported pain in both non-clinical and clinical populations. PMID:25646089

  9. Jejunal perforation after abdominal liposuction, bilateral breast augmentation and facial fat grafting.

    PubMed

    Coronado-Malagón, Martin; Tauffer-Carrion, Luis Tomas

    2012-01-01

    A 54-year-old woman presented to the emergency department 24 h after undergoing abdominal liposuction, bilateral breast augmentation and facial fat grafting at a private plastic surgery clinic. She presented with the classic evolution of a bowel perforation secondary to abdominal liposuction. A computed tomography (CT) scan found free air in her abdominal cavity. Based on the CT scan and the persistent pain experienced by the patient, an abdominal laparatomy was urgently performed. A jejunum perforation was found and was treated with a resection of the affected segment followed by intestinal anastomosis. The patient had a successful recovery and was discharged seven days later. The present article also reviews the classical presentation of a bowel perforation following abdominal liposuction. PMID:23997589

  10. Jejunal perforation after abdominal liposuction, bilateral breast augmentation and facial fat grafting

    PubMed Central

    Coronado-Malagón, Martin; Tauffer-Carrion, Luis Tomas

    2012-01-01

    A 54-year-old woman presented to the emergency department 24 h after undergoing abdominal liposuction, bilateral breast augmentation and facial fat grafting at a private plastic surgery clinic. She presented with the classic evolution of a bowel perforation secondary to abdominal liposuction. A computed tomography (CT) scan found free air in her abdominal cavity. Based on the CT scan and the persistent pain experienced by the patient, an abdominal laparatomy was urgently performed. A jejunum perforation was found and was treated with a resection of the affected segment followed by intestinal anastomosis. The patient had a successful recovery and was discharged seven days later. The present article also reviews the classical presentation of a bowel perforation following abdominal liposuction. PMID:23997589

  11. Obstetrical catastrophe averted: successful outcome of an abdominal pregnancy.

    PubMed

    Joshi, Bharti; Aggarwal, Neelam; Singh, Anju

    2014-10-01

    Abdominal pregnancy is defined as an implantation in peritoneal cavity, exclusive of tubal, ovarian, or intraligmentary pregnancy.These pregnancies are rarely encountered and can go undiagnosed until advanced period of gestation [1]. Frequency of abdominal pregnancy has been directly related to the frequency of ectopic gestation as constituting 2% of ectopics and nearly 0.01% of all pregnancies [2-4]. These pregnancies are seen more commonly in developing countries and poses special challenges to the clinician. Advanced abdominal pregnancy is life-threatening condition and carries high risk of hemorrhage, disseminated intravascular coagulation, bowel injury, and fistulae [5]. The perinatal outcome is mainly influenced by the availability of blood supply and site of implantation [6]. Most of the fetus die in utero because of compromised environment, and those who survive face problems due to congenital malformations [3,7]. Patients of abdominal pregnancy can have variable clinical presentation, and physical examination may be inconclusive for making diagnosis [7,8]. Clinical features like irregular bleeding per vaginum, abdominal pain, dyspepsia, altered bowel habits, malpresentation, and extremely anteriorly placed cervix should raise the suspicion [2,3,8,9]. Diagnostic challenge with oxytocin stimulation, abdominal x-ray, hysterosalpingography, and ultrasonography has been used as tools to assist in diagnosis [10,11]. Magnetic resonance imaging is found to complement sonography in making accurate diagnosis and can be useful to demonstrate the relationship between fetus, the cervix, and the myometrium [12]. We hereby report a successful operative delivery of a live baby after a term extrauterine abdominal pregnancy in a multigravida in whom the diagnosis was made after laparotomy. PMID:24768335

  12. Children and adolescents with complex regional pain syndrome: More psychologically distressed than other children in pain?

    PubMed Central

    Logan, Deirdre E; Williams, Sara E; Carullo, Veronica P; Claar, Robyn Lewis; Bruehl, Stephen; Berde, Charles B

    2013-01-01

    BACKGROUND Historically, in both adult and pediatric populations, a lack of knowledge regarding complex regional pain syndrome (CRPS) and absence of clear diagnostic criteria have contributed to the view that this is a primarily psychiatric condition. OBJECTIVE: To test the hypothesis that children with CRPS are more functionally disabled, have more pain and are more psychologically distressed than children with other pain conditions. METHODS: A total of 101 children evaluated in a tertiary care pediatric pain clinic who met the International Association for the Study of Pain consensus diagnostic criteria for CRPS participated in the present retrospective study. Comparison groups included 103 children with abdominal pain, 291 with headache and 119 with back pain. Children and parents completed self-report questionnaires assessing disability, somatization, pain coping, depression, anxiety and school attendance. RESULTS: Children with CRPS reported higher pain intensity and more recent onset of pain at the initial tertiary pain clinic evaluation compared with children with other chronic pain conditions. They reported greater functional disability and more somatic symptoms than children with headaches or back pain. Scores on measures of depression and anxiety were within normal limits and similar to those of children in other pain diagnostic groups. CONCLUSIONS: As a group, clinic-referred children with CRPS may be more functionally impaired and experience more somatic symptoms compared with children with other pain conditions. However, overall psychological functioning as assessed by self-report appears to be similar to that of children with other chronic pain diagnoses. Comprehensive assessment using a biopsychosocial framework is essential to understanding and appropriately treating children with symptoms of CRPS. PMID:23662291

  13. Spinal pain.

    PubMed

    Izzo, R; Popolizio, T; D'Aprile, P; Muto, M

    2015-05-01

    The spinal pain, and expecially the low back pain (LBP), represents the second cause for a medical consultation in primary care setting and a leading cause of disability worldwide [1]. LBP is more often idiopathic. It has as most frequent cause the internal disc disruption (IDD) and is referred to as discogenic pain. IDD refers to annular fissures, disc collapse and mechanical failure, with no significant modification of external disc shape, with or without endplates changes. IDD is described as a separate clinical entity in respect to disc herniation, segmental instability and degenerative disc desease (DDD). The radicular pain has as most frequent causes a disc herniation and a canal stenosis. Both discogenic and radicular pain also have either a mechanical and an inflammatory genesis. For to be richly innervated, facet joints can be a direct source of pain, while for their degenerative changes cause compression of nerve roots in lateral recesses and in the neural foramina. Degenerative instability is a common and often misdiagnosed cause of axial and radicular pain, being also a frequent indication for surgery. Acute pain tends to extinguish along with its cause, but the setting of complex processes of peripheral and central sensitization may influence its evolution in chronic pain, much more difficult to treat. The clinical assessment of pain source can be a challenge because of the complex anatomy and function of the spine; the advanced imaging methods are often not sufficient for a definitive diagnosis because similar findings could be present in either asymptomatic and symptomatic subjects: a clinical correlation is always mandatory and the therapy cannot rely uniquely upon any imaging abnormalities. Purpose of this review is to address the current concepts on the pathophysiology of discogenic, radicular, facet and dysfunctional pain, focusing on the role of the imaging in the diagnostic setting, to potentially address a correct approach also to minimally invasive interventional techniques. Special attention will be done to the discogenic pain, actually considered as the most frequent cause of chronic low back pain. PMID:25824642

  14. How I Manage Abdominal Injuries.

    ERIC Educational Resources Information Center

    Haycock, Christine E.

    1986-01-01

    In sports, abdominal injuries occur most frequently in cycling, horseback riding, and skiing. Most involve children, not adults. Any athlete sustaining a severe blow to the abdomen should be examined. Guidelines are provided for recognizing and treating injuries to the abdominal muscles, kidneys, spleen, and liver. (Author/MT)

  15. [Hindfoot pain].

    PubMed

    Damiano, Joël; Bouysset, Maurice

    2010-03-20

    The hindfoot is the part of the foot which is proximal to the midtarsal joint. The obvious causes of pain are not considered (post-traumatic etiologies, sprains and fractures but also cutaneous lesions). The main etiologies on the subject are successively exposed by following the localization of the pain. Diffuse pains (ankle arthritis tarsal osteoarthritis, algodystrophy, calcaneo-navicular synostosis but also bone diseases like stress fractures, Paget disease or tumors). Plantar talalgia (Sever's disease, plantar fasciitis and entrapment neuropathies such as (esions of the medial calcaneal nerve, of the first branch of the plantar lateral nerve, medial plantar nerve and lateral plantar nerve). Posterior pains: calcaneal tendinopathy including peritendinitis, tendinosis, retro-calcaneal bursitis and pathology of the postero-lateral talar tuberosity. Medial pains: tendinopathies of the posterior tibial tendon and tendinopathy of the flexor hallucis longus tendon and tarsal tunnel syndrome. Lateral pains: fibularis tendinopathies including split lesions of the fibularis brevis tendon, displacement of the fibularis iongus tendon, sinus tarsi syndrome and finally thickenings of capsules and ligaments and ossifications localized under the tibial malleoli. Anterior pains: antero-inferior tibio-fibular ligament, anterior tibial tendinopathy and anterior impingment syndrome. PMID:20402125

  16. The Influence of Pain-Related Fear on Peak Muscle Activity and Force Generation During Maximal Isometric Trunk Exertions

    Microsoft Academic Search

    James S. Thomas; Christopher R. France; DaoHang Sha; Nicole Vander Wiele

    Study Design. A cross-sectional study of peak activa- tion of trunk muscles in 20 participants with chronic low back pain. Objective. To determine how pain-related fear influ- ences peak activation of abdominal and trunk extensor muscles during maximal isometric trunk exertions. Summary of Background Data. The pain adaptation model and the pain-spasm-pain model have been pro- posed to explain differences

  17. Reproducibility of pain measurement and pain perception

    Microsoft Academic Search

    Elisa M. Rosier; Michael J. Iadarola; Robert C. Coghill

    2002-01-01

    The reproducibility of both the conscious experience of pain and the reproducibility of psychophysical assessments of pain remain critical, yet poorly characterized factors in pain research and treatment. To assess the reproducibility of both the pain experience and two methods of pain assessment, 15 subjects evaluated experimental heat pain during four weekly sessions. In each session, both brief (5s) and

  18. Chronic pain - resources

    MedlinePLUS

    Pain - resources; Resources - chronic pain ... The following organizations are good resources for information on chronic pain: American Chronic Pain Association - www.theacpa.org National Fibromyalgia and Chronic Pain Association - www.fmcpaware.org ...

  19. Clinical Efficacy Comparison of Saccharomyces boulardii and Yogurt Fluid in Acute Non-Bloody Diarrhea in Children: A Randomized, Controlled, Open Label Study

    PubMed Central

    Eren, Makbule; Dinleyici, Ener C.; Vandenplas, Yvan

    2010-01-01

    The purpose of this trial is to evaluate the clinical efficacy and cost/effectiveness of Saccharomyces boulardii compared with yogurt fluid (YF) in acute non-bloody diarrhea in children. This randomized, prospective open-label clinical trial includes 55 children (36 boys, 19 girls; mean age 21.2 ± 28.2 months). Group A (N = 28) received lyophilized S. boulardii and group B (N = 27) received YF. The duration of diarrhea was shorter with S. boulardii but the hospital stay was reduced with YF, although these differences were not significant. However, diarrhea had resolved in significantly more children on day 3 in the S. boulardii group (48.5% versus 25.5%; P < 0.05). In outpatient cases, yogurt treatment was cheaper than S. boulardii whereas in hospitalized patients, treatment cost was similar. In conclusion, the effect of daily freshly prepared YF was comparable to S. boulardii in the treatment of acute non-bloody diarrhea in children. The duration of diarrhea was shorter in the S. boulardii group, expressed as a significantly higher number of patients with normal stools on day 3. PMID:20207879

  20. Peer mentorship to promote effective pain management in adolescents: study protocol for a randomised controlled trial

    Microsoft Academic Search

    Laura B Allen; Jennie CI Tsao; Loran P Hayes; Lonnie K Zeltzer

    2011-01-01

    Background  This protocol is for a study of a new program to improve outcomes in children suffering from chronic pain disorders, such\\u000a as fibromyalgia, recurrent headache, or recurrent abdominal pain. Although teaching active pain self-management skills through\\u000a cognitive-behavioral therapy (CBT) or a complementary program such as hypnotherapy or yoga has been shown to improve pain\\u000a and functioning, children with low expectations

  1. Eye pain

    MedlinePLUS

    ... may be caused by the wrong eyeglass or contact lens prescription. Sometimes they are due to a problem ... that can cause eye pain are: Infections Inflammation Contact lens problems Dry eye Acute glaucoma Sinus problems Neuropathy ...

  2. Neuropathic Pain

    MedlinePLUS

    ... nerve pain, you know that it can erode quality of life. Communication Tools View All Everyday Tools During Your ... each of them. Ability Chart - Arthritis version (PDF) Quality of Life Scale The Quality of Life scale is provided ...

  3. Chest pain

    MedlinePLUS

    ... carries food from the mouth to the stomach) Gallstones cause pain that gets worse after a meal ( ... EM, et al. ACC/AHA Guidelines for the Management of Patients With Unstable Angina and Non-ST- ...

  4. Breast pain

    MedlinePLUS

    ... breast pain. For example, hormone level changes from menstruation or pregnancy often cause breast tenderness. Some amount ... unless a woman is taking hormone replacement therapy) Menstruation and premenstrual syndrome (PMS) Pregnancy -- breast tenderness tends ...

  5. Shoulder pain

    MedlinePLUS

    ... therapist can help you do this safely. Taking ibuprofen or acetaminophen (such as Tylenol) may help reduce ... have had shoulder pain before, use ice and ibuprofen after exercising. Learn exercises to stretch and strengthen ...

  6. Chest Pain

    MedlinePLUS

    Having a pain in your chest can be scary. It does not always mean that you are having a heart attack. ... can be many other causes, including Other heart problems, such as angina Panic attacks Digestive problems, such ...

  7. Anorectal Pain

    Microsoft Academic Search

    Jill C. Genua; Dana R. Sands

    Anorectal pain is distressing for the patient and challenging for the physician. The vague and inconsistent use of terms such\\u000a as proctalgia fugax, levator ani syndrome, spastic pelvic floor, coccygodynia, chronic idiopathic anorectal pain, and pelvic\\u000a floor dyssynergia make it difficult to identify a cause and an effective therapy. Many conditions, some of which may be potentially\\u000a fatal, must be

  8. Chronic diarrhea and abdominal pain: pin the pinworm.

    PubMed

    Rajamanickam, Anitha; Usmani, Ali; Suri, Sanjeev; Dimov, Vesselin

    2009-02-01

    Enterobius vermicularis is the most common helminthic infection in the US. It is usually considered an innocuous parasite that at the most causes perianal itching. We report a case of an 84-year-old female patient from an assisted living facility who presented with symptoms of colitis for 2 months. On detailed history and exam, she was found to have E. vermicularis infection. All her symptoms resolved dramatically within 2 days after a single dose of albendazole. We want to emphasize the importance of including parasitic infections such as E. vermicularis in the differential diagnoses of patients presenting with symptoms of colitis. PMID:19219921

  9. Complementary treatment in fibromyalgia: combination of somatic and abdominal acupuncture.

    PubMed

    Iannuccelli, Cristina; Mannocci, Franca; Guzzo, Maria Paola; Olivieri, Marta; Gerardi, Maria Chiara; Atzeni, Fabiola; Sarzi-Puttini, Piercarlo; Valesini, Guido; Di Franco, Manuela

    2012-01-01

    Fibromyalgia is a complex syndrome characterised by widespread pain associated with a variety of other signs and symptoms. The emerging consensus indicates that the best approach to treatment involves the combination of pharmacological and non-pharmacological interventions. Since acupuncture is a tool of traditional Chinese medicine increasingly used as an alternative or complementary therapy for the treatment of pain, the present study aimed to combine two different acupunctural methods (the somatic and abdominal one) in the treatment of 30 consecutive female FM patients and to evaluate the reduction of pain and the well-being state. The results showed a statistically significant reduction of the number of tender points and of pain. Moreover we observed a statistically significant reduction of FIQ, FAS, HAQ, disease activity VAS, ZSAS, ZSDS at the end of the treatment. In conclusion, these data suggest that the combination of two types of acupuncture could be a useful complementary treatment in FM patients, not only to control pain but also to improve associated symptoms and quality of life. As a result, acupuncture could be very useful to relieve pain in a multidisciplinary setting. PMID:23261009

  10. Neonatal pain

    PubMed Central

    Walker, Suellen M

    2014-01-01

    Effective management of procedural and postoperative pain in neonates is required to minimize acute physiological and behavioral distress and may also improve acute and long-term outcomes. Painful stimuli activate nociceptive pathways, from the periphery to the cortex, in neonates and behavioral responses form the basis for validated pain assessment tools. However, there is an increasing awareness of the need to not only reduce acute behavioral responses to pain in neonates, but also to protect the developing nervous system from persistent sensitization of pain pathways and potential damaging effects of altered neural activity on central nervous system development. Analgesic requirements are influenced by age-related changes in both pharmacokinetic and pharmacodynamic response, and increasing data are available to guide safe and effective dosing with opioids and paracetamol. Regional analgesic techniques provide effective perioperative analgesia, but higher complication rates in neonates emphasize the importance of monitoring and choice of the most appropriate drug and dose. There have been significant improvements in the understanding and management of neonatal pain, but additional research evidence will further reduce the need to extrapolate data from older age groups. Translation into improved clinical care will continue to depend on an integrated approach to implementation that encompasses assessment and titration against individual response, education and training, and audit and feedback. PMID:24330444

  11. SPINAL SEGMENTAL STABILIZATION EXERCISES COMBINED WITH TRADITIONAL STRENGTHENING EXERCISE PROGRAM IN PATIENTS WITH CHRONIC LOW BACK PAIN

    Microsoft Academic Search

    Milica Mirjana Dragan

    SUMMARY Low back pain which lasts for more than 12 weeks is considered chronic lumbar pain. It is the most common diagnosis in physiatry. Numerous highly controlled randomized studies have proved a beneficial effect of the exercises on all symptoms of chronic low back pain. Classic kinesytherapy program does not include strengthening of the deep layer of abdominal and paravertebral

  12. Acute incarcerated external abdominal hernia.

    PubMed

    Yang, Xue-Fei; Liu, Jia-Lin

    2014-11-01

    External abdominal hernia occurs when abdominal organs or tissues leave their normal anatomic site and protrude outside the skin through the congenital or acquired weakness, defects or holes on the abdominal wall, including inguinal hernia, umbilical hernia, femoral hernia and so on. Acute incarcerated hernia is a common surgical emergency. With advances in minimally invasive devices and techniques, the diagnosis and treatment have witnessed major changes, such as the use of laparoscopic surgery in some cases to achieve minimally invasive treatment. However, strict adherence to the indications and contraindications is still required. PMID:25489584

  13. Acute incarcerated external abdominal hernia

    PubMed Central

    Yang, Xue-Fei

    2014-01-01

    External abdominal hernia occurs when abdominal organs or tissues leave their normal anatomic site and protrude outside the skin through the congenital or acquired weakness, defects or holes on the abdominal wall, including inguinal hernia, umbilical hernia, femoral hernia and so on. Acute incarcerated hernia is a common surgical emergency. With advances in minimally invasive devices and techniques, the diagnosis and treatment have witnessed major changes, such as the use of laparoscopic surgery in some cases to achieve minimally invasive treatment. However, strict adherence to the indications and contraindications is still required. PMID:25489584

  14. Pain sensation in pancreatic diseases is not uniform: The different facets of pancreatic pain

    PubMed Central

    D’Haese, Jan G; Hartel, Mark; Demir, Ihsan Ekin; Hinz, Ulf; Bergmann, Frank; Büchler, Markus W; Friess, Helmut; Ceyhan, Güralp O

    2014-01-01

    AIM: To systematically characterize specific pain patterns in the most frequent pancreatic diseases. METHODS: Pain in patients with chronic pancreatitis (n = 314), pancreatic cancer (n = 469), and other pancreatic tumors (n = 249) including mucinous (n = 20) and serous cystadenoma (n = 31), invasive (n = 37) and non-invasive intraductal papillary mucinous neoplasia (IPMN; n = 48), low stage (n = 18) and high stage neuroendocrine neoplasia (n = 44), and ampullary cancer (n = 51) was registered and correlated with clinicopathological data. Survival times were estimated by the Kaplan-Meier method. Patients alive at the follow-up time were censored. Survival curves were compared statistically using the log-rank test. RESULTS: Forty-nine point one percent of pancreatic cancer patients revealed no pain, whereas in chronic pancreatitis only 18.3% were pain free. In contrary, moderate/severe pain was registered in 15.1% in pancreatic cancer patients that was increased in chronic pancreatitis with up to 34.2%. Serous cystadenoma was asymptomatic in most cases (58.1%), whereas 78.9% of all mucinous cystadenoma patients suffered pain. In neuroendocrine neoplasia pain was not a key clinical symptom since 64% of low stage neuroendocrine neoplasia and 59% of high stage neuroendocrine neoplasia patients were pain free. Cancer localization in the pancreatic body and patients with malignant pancreatic neoplasms were associated with more severe pain. Tumor grading and stage did not show any impact on pain. Only in pancreatic cancer, pain was directly associated with impaired survival. CONCLUSION: Pancreatic pain depicts different patterns of abdominal pain sensation according to the respective pancreatic disorder and does not allow a unification of the term pancreatic pain. PMID:25083089

  15. Leukocytosis and high hematocrit levels during abdominal attacks of hereditary angioedema

    PubMed Central

    2013-01-01

    Background The diagnosis of hereditary angioedema (HAE) is often delayed due to the low awareness of this condition. In patients with undiagnosed HAE, abdominal symptoms often create the risk of unnecessary surgical operation and/or drug therapy. To explore the cause of misdiagnosis, we compared the laboratory findings of HAE patients under normal conditions with those during abdominal attacks. Methods Patient medical histories were analyzed and laboratory data at the first consultation with no symptoms and no medication were compared with those at visits to the emergency department during severe attacks. Results Fourteen HAE patients were enrolled. Initial HAE symptoms occurred at 20.2 ± 9.4 years of age. The correct diagnosis of HAE was made 22.7 ± 14.2 years after the initial symptoms. A common site of angioedema was the extremities. Half of the patients experienced a life-threatening laryngeal attack and/or severe abdominal pain. In the patients with severe abdominal pain, significant leukocytosis with neutrophilia along with increased levels of hematocrit were observed while levels of C-reactive protein (CRP) remained low. All severe attacks were alleviated with an infusion of C1-inhibitor concentrate. Conclusions Consideration of the likelihood of a HAE attack is important when patients present with acute abdominal pain and leukocytosis without elevation of CRP. PMID:23915279

  16. Abdominal aortic feminism.

    PubMed

    Mortimer, Alice Emily

    2014-01-01

    A 79-year-old woman presented to a private medical practice 2 years previously for an elective ultrasound screening scan. This imaging provided the evidence for a diagnosis of an abdominal aortic aneurysm (AAA) to be made. Despite having a number of recognised risk factors for an AAA, her general practitioner at the time did not follow the guidance set out by the private medical professional, that is, to refer the patient to a vascular specialist to be entered into a surveillance programme and surgically evaluated. The patient became symptomatic with her AAA, was admitted to hospital and found to have a tender, symptomatic, 6 cm leaking AAA. She consented for an emergency open AAA repair within a few hours of being admitted to hospital, despite the 50% perioperative mortality risk. The patient spent 4 days in intensive care where she recovered well. She was discharged after a 12 day hospital stay but unfortunately passed away shortly after her discharge from a previously undiagnosed gastric cancer. PMID:25398912

  17. Aneurysms: abdominal aortic aneurysms.

    PubMed

    Chun, Kevin C; Lee, Eugene S

    2015-04-01

    Ruptured abdominal aortic aneurysms (AAAs) cause approximately 16,000 deaths per year in the United States. Smoking, male sex, advanced age, hypertension, and family history are risk factors. AAAs suspected on physical examination should be evaluated with ultrasonography. In addition, ultrasonography screening for AAA is recommend for men ages 65 to 75 years with smoking histories. For men ages 65 to 75 years who have never smoked, screening should be performed selectively, such as for those with family histories of AAA. Screening women currently is not recommended, regardless of smoking status. Surgical repair is indicated for men with AAA diameters of 5.5 cm or greater. The common practice for women is to repair AAAs with diameters of 5.0 cm or greater. For patients with smaller AAAs, cardiac risk factor management is recommended along with interval ultrasonography monitoring. Surgery is indicated if monitoring shows that an AAA is enlarging (by 1 cm or more per year) or reaches the noted limits. Repair of AAA (ruptured or unruptured) is accomplished with open surgery or endovascular procedures (eg, transcatheter placement of a stent graft). Endovascular procedures are now used more frequently than open surgery and have similar outcomes. PMID:25860135

  18. [Forefoot pain].

    PubMed

    Damiano, Joël

    2010-03-20

    Forefoot chronic pain is a frequent problem in daily clinical practice. Mechanical pathology of the forefoot, usually called static metatarsalgia, represents the most frequent reason for consultation in pathology of the foot. The cause is a functionnal disorder or anatomic derangement of the forefoot architecture. Metatarsalgia can originate from a wide range of affections. Etiologies of chronic pain are described from medial to lateral with first ray pathologies (hallux valgus, hallux rigidus and sesamoid pathology) and first ray insufficiency, pathologies of the second, third and fourth ray and intermetatarsal spaces (second ray syndrome, Freiberg's disease, Morton neuroma, stress or bone insufficiency metatarsal fractures, intermetatarsal bursitis) and fifth ray pathology (lateral bursitis, quintus varus). Sometimes forefoot pain could also be caused by chronic inflammatory rheumatic diseases (rheumatoid and psoriatic arthritis) with a risk of structural metatarsophalangeal joints alteration. The pathology of the toes can, more rarely, explain a forefoot pain. So, several pathologic conditions can produce forefoot pain and the diagnostic approach must always be based on the anamnesis and clinical examination. In a second time if the cause is difficult to establish based solely on clinical findings, radiography and ultrasonography are today the most usefull auxiliary investigations. PMID:20402124

  19. “Toxic Pancreatitis with an Intra-Abdominal Abscess which was Caused by Organophosphate Poisoning (OP)”

    PubMed Central

    L, Venugopal; Rao V, Dharma; Rao M, Srinivas; Y, Mallikarjuna

    2013-01-01

    Organophosphate insecticides are the potent inhibitors of the acetylcholinesterase enzyme which lead to an increased acetylcholine activity, which are responsible for symptoms such as abdominal pain, diarrhoea, vomiting and hypersalivation. We are reporting on a young male with acute organophosphate poisoning, who presented with unusual complications like toxic pancreatitis with an intraabdominal abscess. PMID:23543622

  20. Diagnosis and management of angioedema with abdominal involvement: A gastroenterology perspective

    PubMed Central

    Nzeako, Ugochukwu C

    2010-01-01

    Abdominal involvement in angioedema is often a challenge to diagnose. Acute onset abdominal pain is its most common presenting symptom, and misdiagnosis may lead to unnecessary surgical intervention. Familiarity with the types and presentations of angioedema can be invaluable to clinicians as they consider the differential diagnoses of a patient presenting with abdominal pain. Detailed personal and family histories, careful physical examination of the patient, combined with knowledge of angioedema types, can help clinicians perform their diagnostic evaluation. An accurate diagnosis is essential in order to provide appropriate treatment to patients with angioedema. Depending upon the diagnosis, treatment may be the avoidance of provoking factors (such as allergens or medications), inhibiting histamine-provoked reactions, or treating C1 esterase inhibitor deficiency. PMID:20954277

  1. Cholelithiasis Presented as Chronic Right Back Pain

    PubMed Central

    Bobé-Armant, Francesc; Buil-Arasanz, Maria Eugenia; Trubat-Muñoz, Griselda; Llor-Vilà, Carles; Vicente-Guillen, Vicente

    2014-01-01

    Chronic right back pain is a symptom in both biliary lithiasis and chronic cholecystitis. Ten percent of the population in the world suffers from biliary lithiasis. Only 20% are symptomatic. The first diagnostic test of choice is an abdominal ultrasound. When a suggestive clinical sign of biliary colic with negative abdominal ultrasound is identified, we should consider the option of carrying out an endoscopic ultrasound in order to rule out microlithiasis. The case discussed in the report presented with chronic right back pain, which is an atypical manifestation of biliary lithiasis and chronic cholecystitis. It is important to know about the atypical manifestations of the prevalent illnesses as well as the limits of the diagnostic tests, in order to avoid diagnostic delays which may cause complications that could worsen a patient's prognosis. This case should contribute to the medical knowledge and must have educational value or highlight the need for a change in clinical practice, especially in primary care. PMID:25657967

  2. Back Pain

    NSDL National Science Digital Library

    Patient Education Institute

    This patient education program reviews the anatomy of the back, the most common causes of back pain, and measures to prevent back pain. This resource is a MedlinePlus Interactive Health Tutorial from the National Library of Medicine, designed and developed by the Patient Education Institute. NOTE: This tutorial requires a special Flash plug-in, version 4 or above. If you do not have Flash, you will be prompted to obtain a free download of the software before you start the tutorial. You will also need an Acrobat Reader, available as a free download, in order to view the Reference Summary.

  3. Comparison of Abdominal Muscle Activity in Relation to Knee Angles during Abdominal Drawing-in Exercises Using Pressure Biofeedback.

    PubMed

    Lee, Jun-Cheol; Lee, Su-Kyoung; Kim, Kyoung

    2013-10-01

    [Purpose] The leg angles that are the most effective for abdominal muscle activation were investigated by performing abdominal drawing-in exercises at different leg angles with a biofeedback pressure unit. [Methods] Subjects were asked to adopt a supine position, and the tip of the biofeedback pressure unit was placed under the posterior superior iliac spine. Then, the pressure was adjusted to 40 mmHg while referring to the pressure gauge connected to the biofeedback pressure unit. Subjects were instructed to increase the pressure by 10 mmHg using the drawing-in technique upon the oral instruction, "Start," and to maintain the drawn-in state. The time during which the pressure was maintained within an error range of ±1-2mmHg was measured in seconds. [Result] During the abdominal drawing-in exercises, the activity of the rectus abdominis, the internal and external obliques, and the transverse abdominis increased as the knee joint flexion angle increased from 45° to 120°. [Conclusion] When trunk stabilization exercises are performed at the same pressure to reduce damage after the acute phase of low back pain, trunk muscle strength can be efficiently increased by increasing the knee joint angle gradually, while performing abdominal drawing-in exercises with a biofeedback pressure unit. PMID:24259770

  4. Inflammatory Back Pain vs. Mechanical Back Pain

    MedlinePLUS Videos and Cool Tools

    ... cause. Specifically, is the back pain inflammatory in nature or mechanical? INFLAMMATORY VS MECHANICAL BACK PAIN VIDEO: ... determing if the back pain is inflammatory in nature and related to a disease such as ankylosing ...

  5. Pain management in AIDS. Interview by Ronald Baker.

    PubMed

    Breitbart, W; Lefkowitz, M; Levin, J

    1995-06-01

    An edited transcript of two BETA LIVE! national telephone conference calls held April 18 and April 20, 1995 is provided. Pain experts Dr. William Breitbart and Dr. Matthew Lefkowitz discuss pain management in AIDS. Jules Levin discusses protease inhibitor drug development. Pain syndromes associated with AIDS include abdominal pain, peripheral neuropathy, and oropharyngeal pain. Headache pain, post-herpetic neuralgia, and musculoskeletal pain, although lower in incidence, also affect people with AIDS. Barriers to the treatment of pain are associated with health care providers and the patients themselves. Women with HIV are twice as likely to be undertreated for their pain than men with HIV. Patients with less education and those with a history of injection drug use are also likely to be undertreated for pain. Chronic pain in patients with AIDS is complex and involves treatment that looks at the physical, psychological, and emotional aspects of pain. Jules Levin, coordinator of the Protease Inhibitor Working Groups, discusses the importance of protease inhibitors and their status. Three protease inhibitor drugs are under development by three companies--La Roche, Merck and Abbott. The Merck and Abbott drugs are entering Phase III trials. Roche is planning an expanded access program for 4,000 people for its drug, saquinavir. All three companies have indicated that they will apply for accelerated approval. PMID:11362550

  6. Isolated abdominal wound recurrence after lymph-node dissection for appendiceal adenocarcinoma.

    PubMed

    Yamaguchi, Hironori; Ishimaru, Masahiro; Suzuki, Hiroyuki; Yamashita, Hiroharu; Hatanaka, Kazuhito; Uekusa, Toshimasa; Nagawa, Hirokazu

    2010-01-01

    A 47-year-old man with acute abdominal pain in the right lower quadrant underwent an appendectomy via McBurney's incision. Postoperative histology revealed a moderately differentiated adenocarcinoma in the appendix that invaded the submucosa along with lymphatic involvement. Forty-three days later, an ileocecal resection with radical lymph node dissection was performed through a midline incision. Three of the 30 resected lymph nodes were found to have adenocarcinoma metastasis. Five years later, an isolated abdominal wall recurrence occurred within the wound scar of the midline incision. A complete excision of the tumor and the invaded portion of the ileum was performed. To date, the patient has been well, with no evidence of recurrence for 5 years since the resection. The mechanism of abdominal wound recurrence is considered the leakage of carcinoma cells from transected lymph vessels during lymph node dissection, followed by the implantation of these cells into the abdominal wound. PMID:19837396

  7. Achilles Pain.

    ERIC Educational Resources Information Center

    Connors, G. Patrick

    Five ailments which can cause pain in the achilles tendon area are: (1) muscular strain, involving the stretching or tearing of muscle or tendon fibers; (2) a contusion, inflammation or infection called tenosynovitis; (3) tendonitis, the inflammation of the tendon; (4) calcaneal bursitis, the inflammation of the bursa between the achilles tendon…

  8. Leg pain

    MedlinePLUS

    ... bone tumors ( osteosarcoma , Ewing sarcoma) Legg-Calve-Perthes disease -- poor blood flow to the hip that may stop or slow the normal growth of the leg Noncancerous (benign) tumors or cysts of the femur or tibia (osteoid osteoma) Sciatic nerve pain (radiating ...

  9. Central Pain Syndrome

    MedlinePLUS

    NINDS Central Pain Syndrome Information Page Table of Contents (click to jump to sections) What is Central Pain Syndrome? Is there ... being done? Clinical Trials Organizations What is Central Pain Syndrome? Central pain syndrome is a neurological condition ...

  10. Somatoform pain disorder

    MedlinePLUS

    Pain disorder ... thought to be related to emotional stress. The pain was often said to be "all in their head." However, patients with somatoform pain disorder seem to experience painful sensations in a ...

  11. Peritoneal Response to Abdominal Surgery: The Role of Equine Abdominal Adhesions and Current Prophylactic Strategies

    PubMed Central

    Alonso, Juliana de Moura; Alves, Ana Liz Garcia; Watanabe, Marcos Jun; Rodrigues, Celso Antonio; Hussni, Carlos Alberto

    2014-01-01

    Intra-abdominal adhesions constitute a significant clinical and surgical problem that can lead to complications such as pain and bowel occlusion or subocclusion. These adhesions are frustrating and potentially fatal, representing a major postoperative complication in abdominal surgery. It is estimated that 32% of horses undergoing laparotomy will present clinical symptoms due to adhesions, but the true prevalence is not known because a large proportion of animals with postoperative recurrent colics are medically treated or submitted to euthanasia without necropsy. Adhesions are highly cellular, vascularized, dynamic structures that are influenced by complex signaling mechanisms. Understanding their pathogenesis could assist in applying better therapeutic strategies and in developing more effective antiadhesion products. Currently, there are no definitive strategies that prevent adhesion formation, and it is difficult to interpret the results of existing studies due to nonstandardization of an induction model and evaluation of their severity. The best clinical results have been obtained from using minimally traumatic surgical techniques, anti-inflammatory agents, antimicrobials, anticoagulants, and mechanical separation of serosal surfaces by viscous intraperitoneal solutions or physical barriers. This paper aims to review adhesion formation pathogenesis, guide the understanding of major products and drugs used to inhibit adhesion formation, and address their effectiveness in the equine species. PMID:24587939

  12. Risk factors for equine acute abdominal disease (colic): Results from a multi-center case-control study

    Microsoft Academic Search

    Mathew J. Reeves; Mo D. Salman; Gary Smith

    1996-01-01

    Many causal hypotheses for acute equine abdominal disease (colic) have been proposed. However, few epidemiologic studies have been undertaken to identify risk factors for the syndrome. Risk factors for equine colic were identified using a hospital-based, multi-center, case-control study. Horses admitted with abdominal pain to Cornell, Guelph, Ohio State, Pennsylvania or Tufts university veterinary hospitals between March and December 1991

  13. Clinical Issues in Pain Management Clinical Issues in Pain Management

    E-print Network

    Meagher, Mary

    #12;Clinical Issues in Pain Management: Chronic Pain Chronic Pain Typically begins with an acute of chronic pain Chronic benign pain Recurrent acute pain Chronic progressive pain #12;Clinical Issues in Pain Management: Chronic Pain Chronic benign pain Persists more than 6 months Varies in severity

  14. Interventional therapies for the management of cancer pain.

    PubMed

    Brogan, Shane; Junkins, Scott

    2010-01-01

    Timely interventional cancer pain therapies complement conventional pain management by reducing the need for high-dose opioid therapy and its associated toxicity. All patients with upper abdominal visceral pain should be considered for celiac plexus neurolysis soon after diagnosis. Intrathecal therapy should be considered in any patient with moderate-to-severe pain despite a reasonable therapeutic trial of opioid pharmacotherapy or in any patient intolerant of opioid therapy. Specific interventions for vertebral metastases and other sites of metastatic bone pain, including vertebroplasty, kyphoplasty, and image-guided tumor ablation, should be understood and considered. A collaborative model of care, including pain medicine specialists with expertise in interventional therapies, should be standard in all oncologic practices in order to optimize outcomes for patients with cancer throughout the course of their treatment. PMID:20464881

  15. Ultrasound Screening for Abdominal Aortic Aneurysm

    PubMed Central

    2006-01-01

    Executive Summary Objective The aim of this review was to assess the effectiveness of ultrasound screening for asymptomatic abdominal aortic aneurysm (AAA). Clinical Need Abdominal aortic aneurysm is a localized abnormal dilatation of the aorta greater than 3 cm. In community surveys, the prevalence of AAA is reported to be between 2% and 5.4%. Abdominal aortic aneurysms are found in 4% to 8% of older men and in 0.5% to 1.5% of women aged 65 years and older. Abdominal aortic aneurysms are largely asymptomatic. If left untreated, the continuing extension and thinning of the vessel wall may eventually result in rupture of the AAA. Often rupture may occur without warning, causing acute pain. Rupture is always life threatening and requires emergency surgical repair of the ruptured aorta. The risk of death from ruptured AAA is 80% to 90%. Over one-half of all deaths attributed to a ruptured aneurysm take place before the patient reaches hospital. In comparison, the rate of death in people undergoing elective surgery is 5% to 7%; however, symptoms of AAA rarely occur before rupture. Given that ultrasound can reliably visualize the aorta in 99% of the population, and its sensitivity and specificity for diagnosing AAA approaches 100%, screening for aneurysms is worth considering as it may reduce the incidence of ruptured aneurysms and hence reduce unnecessary deaths caused by AAA-attributable mortality. Review Strategy The Medical Advisory Secretariat used its standard search strategy to retrieve international health technology assessments and English-language journal articles from selected databases to determine the effectiveness of ultrasound screening for abdominal aortic aneurysms. Case reports, letters, editorials, nonsystematic reviews, non-human studies, and comments were excluded. Questions asked: Is population-based AAA screening effective in improving health outcomes in asymptomatic populations? Is AAA screening acceptable to the population? Does this affect the effectiveness the screening program? How often should population-based screening occur? What are appropriate treatment options after screening based on the size of aneurysms? Are there differences between universal and targeted screening strategies? What are the harms of screening? Summary of Findings Population-based ultrasound screening is effective in men aged 65 to 74 years, particularly in those with a history of smoking. Screening reduces the incidence of AAA ruptures, and decreases rates of emergency surgical repair for AAA and AAA-attributable mortality. Acceptance rates decline with increasing age and are lower for women. Low acceptance rates may affect the effectiveness of a screening program. A one-time screen is sufficient for a population-based screening program with regard to initial negative scans and development of large AAAs. There is no difference between early elective surgical repair and surveillance for small aneurysms (4.0–5.4 cm). Repeated surveillance of small aneurysms is recommended. Targeted screening based on history of smoking has been found to detect 89% of prevalent AAAs and increase the efficiency of screening programs from statistical modeling data. Women have not been studied for AAA screening programs. There is evidence suggesting that screening women for AAA should be considered with respect to mortality and case fatality rates in Ontario. It is important that further evaluation of AAAs in women occur. There is a small risk of physical harm from screening. Less than 1% of aneurysms will not be visualized on initial screen and a re-screen may be necessary; elective surgical repair is associated with a 6% operative morality rate and about 3% of small aneurysms may rupture during surveillance. These risks should be communicated through informed consent prior to screening. There is little evidence of severe psychological harms associated with screening. Conclusions Based on this review, the Medical Advisory Secretariat concluded that there is sufficient evidence to determine that AAA screening using ultrasound is effective

  16. Interventional modalities to treat cancer-related pain.

    PubMed

    Moeschler, Susan M; Rosenberg, Casandra; Trainor, Drew; Rho, Richard H; Mauck, W David

    2014-12-01

    Cancer-related pain is a significant cause of morbidity in those affected by both primary and metastatic disease. Although oral, transdermal, and parenteral opioid medications are an integral part of the World Health Organization's analgesic ladder, their use may be limited by side effects. Fortunately, there are advanced interventional pain management strategies effective in reducing pain in the cancer patient while mitigating the aforementioned side effects. Celiac plexus blocks and neurolysis have been proven effective in treating cancers of the abdominal viscera (ie, pancreas). Transversus abdominis plane blocks, neurolysis, and catheter placement can be used to treat cancer pain associated with the abdominal wall. Peripheral nerve blocks and catheter placement at the brachial and lumbosacral plexus or peripheral nerves treat cancer pain associated with the upper and lower limbs, whereas paravertebral and intercostal blocks treat cancer pain associated with the chest wall and ribs. Finally, alternate drug delivery methods such as intrathecal drug delivery systems concentrate medication at central opioid receptors without affecting the peripheral receptors implicated in unwanted side effects. This article provides an overview of these interventions, including indications, contraindications, and potential complications of advanced interventional pain management options available for the treatment of intractable cancer-related pain. PMID:25485914

  17. Abdominal radiation causes bacterial translocation

    SciTech Connect

    Guzman-Stein, G.; Bonsack, M.; Liberty, J.; Delaney, J.P.

    1989-02-01

    The purpose of this study was to determine if a single dose of radiation to the rat abdomen leads to bacterial translocation into the mesenteric lymph nodes (MLN). A second issue addressed was whether translocation correlates with anatomic damage to the mucosa. The radiated group (1100 cGy) which received anesthesia also was compared with a control group and a third group which received anesthesia alone but no abdominal radiation. Abdominal radiation lead to 100% positive cultures of MLN between 12 hr and 4 days postradiation. Bacterial translocation was almost nonexistent in the control and anesthesia group. Signs of inflammation and ulceration of the intestinal mucosa were not seen until Day 3 postradiation. Mucosal damage was maximal by Day 4. Bacterial translocation onto the MLN after a single dose of abdominal radiation was not apparently dependent on anatomical, histologic damage of the mucosa.

  18. Lap Pak for Abdominal Retraction

    PubMed Central

    Sivarajan, Ganesh; Chang, Sam S; Fergany, Amr; Malkowicz, S. Bruce; Steinberg, Gary D; Lepor, Herbert

    2012-01-01

    Retraction of the bowels during abdominal surgery is generally facilitated by the use of a combination of various retractors along with surgical towels or sponges. The use of surgical towels and sponges may lead to retained foreign bodies or adhesions. In addition, these towels and sponges often require manipulation during long surgical procedures. The ideal way to avoid these problems in abdominal surgery is to develop a technique for retraction of the abdominal contents that eliminates the requirement for these foreign bodies. This article presents the results of a small trial for Lap Pak (Seguro Surgical, Columbia, MD), a disposable radio-opaque device that is made of silicone and retracts the bowels in a cephalad orientation without the need for towels or sponges. PMID:23526186

  19. Neck pain

    PubMed Central

    2008-01-01

    Introduction Non-specific neck pain has a postural or mechanical basis and affects about two thirds of people at some stage, especially in middle age. Acute neck pain resolves within days or weeks, but may become chronic in about 10% of people. Whiplash injuries follow sudden acceleration–deceleration of the neck, such as in road traffic or sporting accidents. Up to 40% of people continue to report symptoms 15 years after the accident, although this varies between countries. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatments for people with non-specific neck pain without severe neurological deficit? What are the effects of treatments for acute whiplash injury? What are the effects of treatments for chronic whiplash injury? What are the effects of treatments for neck pain with radiculopathy? We searched: Medline, Embase, The Cochrane Library, and other important databases up to May 2007 (BMJ Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 91 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of the evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: acupuncture, biofeedback, drug treatments (analgesics, antidepressants, epidural steroid injections, muscle relaxants, non-steroidal anti-inflammatory drugs [NSAIDs]), early mobilisation, early return to normal activity, exercise, heat or cold, manipulation (alone or plus exercise), mobilisation, multimodal treatment, patient education, percutaneous radiofrequency neurotomy, physical treatments, postural techniques (yoga, pilates, Alexander technique), pulsed electromagnetic field (PEMF) treatment, soft collars and special pillows, spray and stretch, surgery, traction, and transcutaneous electrical nerve stimulation (TENS). PMID:19445809

  20. Intensity, location, and quality of pain in Spanish-speaking children with cancer.

    PubMed

    Jacob, Eufemia; McCarthy, Kathy S; Sambuco, Gennaro; Hockenberry, Marilyn

    2008-01-01

    Spanish speaking children with cancer were asked to describe their pain during the previous week prior to an oncology clinic appointment. Data showed that 41% of the children were experiencing pain and the overall mean pain intensity rating among these children was 5.7 +/- 2.7. Among those children with moderate to severe pain, the most frequently marked locations on the body outline diagram was the abdomen (53.8%), lower back (46.2%), and upper chest (30.8%). The higher percentage of children complaining of abdominal pain may be attributed to the high percentage (63.6%) of children reporting oral chemotherapy at home. Some children experienced pain that was unrecognized and undetected, and therefore were not receiving medications. To minimize the risk of under-treatment of pain, children and parents may be taught to use the Spanish version of the Adolescent Pediatric Pain Tool to communicate the child's pain to clinicians. PMID:18361086

  1. Abdominal Bloating: Pathophysiology and Treatment

    PubMed Central

    Seo, A Young; Oh, Dong Hyun

    2013-01-01

    Abdominal bloating is a very common and troublesome symptom of all ages, but it has not been fully understood to date. Bloating is usually associated with functional gastrointestinal disorders or organic diseases, but it may also appear alone. The pathophysiology of bloating remains ambiguous, although some evidences support the potential mechanisms, including gut hypersensitivity, impaired gas handling, altered gut microbiota, and abnormal abdominal-phrenic reflexes. Owing to the insufficient understanding of these mechanisms, the available therapeutic options are limited. However, medical treatment with some prokinetics, rifaximin, lubiprostone and linaclotide could be considered in the treatment of bloating. In addition, dietary intervention is important in relieving symptom in patients with bloating. PMID:24199004

  2. Pain and the ethics of pain management

    Microsoft Academic Search

    Rem B. Edwards

    1984-01-01

    In this article I clarify the concepts of 'pain', 'suffering', 'pains of body', 'pains of soul'. I explore the relevance of an ethic to the clinical setting which gives patients a strong prima facie right to freedom from unnecessary and unwanted pain and which places upon medical professionals two concomitant moral obligations to patients. First, there is the duty not

  3. EMG activity of trunk muscles and torque output during isometric axial rotation exertion: a comparison between back pain patients and matched controls

    Microsoft Academic Search

    Joseph K.-F. Ng; Carolyn A. Richardson; Mohamad Parnianpour; Vaughan Kippers

    2002-01-01

    Abnormal patterns of trunk muscle activity could affect the biomechanics of spinal movements and result in back pain. The present study aimed to examine electromyographic (EMG) activity of abdominal and back muscles as well as triaxial torque output during isometric axial rotation at different exertion levels in back pain patients and matched controls. Twelve back pain patients and 12 matched

  4. Many faces of angioedema: focus on the diagnosis and management of abdominal manifestations of hereditary angioedema.

    PubMed

    Nzeako, Ugochukwu C; Longhurst, Hilary J

    2012-04-01

    Angioedema of the intestinal tract is an infrequent but well-described cause of abdominal pain that can occur because of inherited, acquired, allergic, or drug-induced causes. Hereditary angioedema (HAE) is a genetic disorder that causes recurrent attacks of severe edema of various body parts, including the intestinal tract. Moderate to severe abdominal pain occurs in 43-93% of such attacks due to intestinal edema. Laryngeal edema is a potentially life-threatening manifestation. Failure to recognize and diagnose HAE or other causes of intestinal angioedema can lead to years of delay in diagnosis, and in the case of HAE, often to unnecessary abdominal surgeries. Recognizing the typical history of recurrent attacks of abdominal pain, oropharyngeal/laryngeal angioedema or cutaneous angioedema, family history of similar symptoms, association of attacks with stress or menses, and exacerbation of attacks after administration of estrogens or angiotensin-converting enzyme inhibitors will increase diagnostic accuracy. Interdisciplinary treatment is often necessary after the diagnosis of HAE, first with acute management in the emergency room or the intensive care unit, followed by either drug prophylaxis against future attacks using a C1-esterase inhibitor concentrate or attenuated androgens and discontinuation of medications known to trigger attacks. Newer drugs approved for treatment of acute attacks may have future roles in the prevention of attacks if further studies support their efficacy. Gastroenterologists in particular should maintain a high index of suspicion for the possibility of HAE or other causes of intestinal angioedema in patients with a history of recurrent abdominal pain. PMID:22410711

  5. Abdominal obesity and metabolic syndrome

    Microsoft Academic Search

    Jean-Pierre Després; Isabelle Lemieux

    2006-01-01

    Metabolic syndrome is associated with abdominal obesity, blood lipid disorders, inflammation, insulin resistance or full-blown diabetes, and increased risk of developing cardiovascular disease. Proposed criteria for identifying patients with metabolic syndrome have contributed greatly to preventive medicine, but the value of metabolic syndrome as a scientific concept remains controversial. The presence of metabolic syndrome alone cannot predict global cardiovascular disease

  6. [Unusual cause of abdominal lymphomas].

    PubMed

    Halevy, D; Schöntag, S; Küper-Steffen, R; Lobmann, R

    2011-06-01

    A 72 year old HIV-negative patient without relevant immunosuppression presented with abdominal lymphomas and inflammatory signs in the colon. Mycobacterium intracellulare was grown from colonic biopsies and stool. There was no sign of malignancy or chronic inflammatory bowel disease. We diagnosed an atypical, gastrointestinal mycobacteriosis und treated the patient accordingly. This led to a good response. PMID:20945056

  7. Post-operative analgesia for major abdominal surgery and its effectiveness in a tertiary care hospital

    PubMed Central

    Ahmed, Aliya; Latif, Naveed; Khan, Robyna

    2013-01-01

    Background: Post-operative pain is often inadequately treated. Optimal utilization of the available resources is essential for improving pain management. Aims: The aim of our study was to determine pain management strategies employed after major abdominal surgeries at our institute and their efficacy and safety. Settings and Design: Prospective observational study conducted at a tertiary care hospital. Materials and Methods: Patients undergoing elective major abdominal surgeries were included. Post-operative analgesic strategy, co-analgesics used, pain and sedation scores, motor block, nausea and vomiting were recorded and patient satisfaction was determined. Results: Data was collected on 100 patients. Epidural analgesia was used in 61, patient controlled intravenous analgesia (PCIA) in 25 and opioid infusion in 14 patients. Multimodal analgesia was employed in 98 patients. The level of epidural was between L1-L3 in 31, T10-L1 in 20 and T8-T10 in 10 patients. Pethidine was used in 80% of patients receiving PCIA. Patients with epidurals at T8-T10 had lower pain scores. Fifteen patients had motor block, 73% of which were with epidural at L1-L3. Fourteen patients complained of nausea. Ninety nine out of 100 patients were satisfied with their analgesia. Conclusion: Epidural, PCIA and opioid infusions are used for pain relief after major abdominal surgeries at our hospital. Although there is limited drug availability, regular assessments and appropriate dose adjustments by acute pain management service (APMS) and use of multimodal analgesia led to a high level of patient satisfaction. We recommend that feedback to the primary anesthesiologists by APMS is of utmost importance to enable improvement in practice. PMID:24249983

  8. Abdominal miliary tuberculosis in a patient with AIDS: a case report.

    PubMed

    Pop, Monica; Pop, Cezar; Homorodean, Daniela; Itu, Corina; Man, Milena; Goron, Monica; Gherasim, Ruxandra; Coroiu, Georgiana

    2003-09-01

    We present a 34 year old patient, intravenous drug user, hospitalized with fever, distortion of general status, dry irritating cough, abdominal colicative pains, and we established the diagnosis of HIV infection advanced stage/AIDS; his antecedents revealed (August 2000) abdominal tuberculosis not treated during the last 3 months. He presented a pneumonia with Pneumocystis carinii during hospitalization. Death was due to a colon perforation with secundary peritonitis. Miliary tuberculous lesions in liver, spleen and colon were revealed at necropsy and cytomegalovirus was identified in necrotic samples also. PMID:14502324

  9. Intra-abdominal hemorrhage associated with a granulosa-thecal cell neoplasm in a mare.

    PubMed

    Gatewood, D M; Douglass, J P; Cox, J H; DeBowes, R M; Kennedy, G A

    1990-06-01

    A 9-year-old American Saddlebred mare was referred because of abdominal distention and signs of abdominal pain. Copious peritoneal fluid obtained by abdominocentesis appeared to be frank blood. Rectal and ultrasonographic evaluation of the abdomen revealed a large mass at the distal tip of the right uterine horn. The mare was euthanatized and necropsied and the mass was determined to be a granulosa-thecal cell neoplasm. The most common clinical sign of granulosa-thecal cell neoplasm is infertility or abnormal sexual behavior. Hemoperitoneum is infrequently associated with neoplasms in horses. PMID:2161811

  10. Inherited Pain

    PubMed Central

    Eberhardt, Mirjam; Nakajima, Julika; Klinger, Alexandra B.; Neacsu, Cristian; Hühne, Kathrin; O'Reilly, Andrias O.; Kist, Andreas M.; Lampe, Anne K.; Fischer, Kerstin; Gibson, Jane; Nau, Carla; Winterpacht, Andreas; Lampert, Angelika

    2014-01-01

    Inherited erythromelalgia (IEM) causes debilitating episodic neuropathic pain characterized by burning in the extremities. Inherited “paroxysmal extreme pain disorder” (PEPD) differs in its clinical picture and affects proximal body areas like the rectal, ocular, or jaw regions. Both pain syndromes have been linked to mutations in the voltage-gated sodium channel Nav1.7. Electrophysiological characterization shows that IEM-causing mutations generally enhance activation, whereas mutations leading to PEPD alter fast inactivation. Previously, an A1632E mutation of a patient with overlapping symptoms of IEM and PEPD was reported (Estacion, M., Dib-Hajj, S. D., Benke, P. J., Te Morsche, R. H., Eastman, E. M., Macala, L. J., Drenth, J. P., and Waxman, S. G. (2008) NaV1.7 Gain-of-function mutations as a continuum. A1632E displays physiological changes associated with erythromelalgia and paroxysmal extreme pain disorder mutations and produces symptoms of both disorders. J. Neurosci. 28, 11079–11088), displaying a shift of both activation and fast inactivation. Here, we characterize a new mutation of Nav1.7, A1632T, found in a patient suffering from IEM. Although transfection of A1632T in sensory neurons resulted in hyperexcitability and spontaneous firing of dorsal root ganglia (DRG) neurons, whole-cell patch clamp of transfected HEK cells revealed that Nav1.7 activation was unaltered by the A1632T mutation but that steady-state fast inactivation was shifted to more depolarized potentials. This is a characteristic normally attributed to PEPD-causing mutations. In contrast to the IEM/PEPD crossover mutation A1632E, A1632T failed to slow current decay (i.e. open-state inactivation) and did not increase resurgent currents, which have been suggested to contribute to high-frequency firing in physiological and pathological conditions. Reduced fast inactivation without increased resurgent currents induces symptoms of IEM, not PEPD, in the new Nav1.7 mutation, A1632T. Therefore, persistent and resurgent currents are likely to determine whether a mutation in Nav1.7 leads to IEM or PEPD. PMID:24311784

  11. Treating Postlaparoscopic Surgery Shoulder Pain with Acupuncture

    PubMed Central

    Attias, Samuel; Kreindler, Anna; Hen, Haim; Haj, Bassel; Matter, Ibrahim; Ben-Arye, Eran; Schiff, Elad

    2014-01-01

    Objective. The purpose of this study was to examine the effect of acupuncture on postlaparoscopic shoulder pain (PLSP) which is a common side effect in patients undergoing abdominal laparoscopic surgery. Methods. Patients with moderate to severe PLSP in spite of analgesic treatment, which were referred by the medical staff to the Complementary-Integrative Surgery Service (CISS) at our institution, were provided with acupuncture treatment. The severity of PLSP and of general pain was assessed using a Visual Analogue Scale (VAS) from 0 to 10. Pain assessment was conducted prior to and two hours following acupuncture treatment. Acupuncture treatment was individualized based on traditional Chinese medicine diagnosis. Results. A total of 25 patients were evaluated during a 14-month period, from March 2011 to May 2012. A significant reduction in PLSP (mean reduction of 6.4 ± 2.3?P < 0.0001) and general pain (mean reduction 6.4 ± 2.1?P < 0.0001) were observed, and no significant side effects were reported. Conclusion. Individualized acupuncture treatments according to traditional Chinese medicine principles may improve postlaparoscopic shoulder pain and general pain when used in conjunction with conventional therapy. The primary findings of this study warrant verification in controlled studies. PMID:24864149

  12. Vaginal mesh erosion after abdominal sacral colpopexy

    Microsoft Academic Search

    Anthony G. Visco; Alison C. Weidner; Matthew D. Barber; Evan R. Myers; Geoffrey W. Cundiff; Richard C. Bump; W. Allen Addison

    2001-01-01

    Objective: Our goal was to compare the prevalence of vaginal mesh erosion between abdominal sacral colpopexy and various sacral colpoperineopexy procedures. Study Design: We undertook a retrospective analysis of all sacral colpopexies and colpoperineopexies performed between March 1, 1992, and February 28, 1999. The patients were divided into the following 4 groups: abdominal sacral colpopexy, abdominal sacral colpoperineopexy, and 2

  13. Abdominal Compartment Syndrome in the Open Abdomen

    Microsoft Academic Search

    Vicente H. Gracias; Benjamin Braslow; Jon Johnson; John Pryor; Rajan Gupta; Patrick Reilly; C. William Schwab

    2002-01-01

    Background: Multiple methods exist to manage in the intensive care unit the patient with an open abdomen. An increasingly common method is the vacuum packed technique. This method accommodates considerable ex- pansion of intra-abdominal contents and should obvi- ate the potential development of the abdominal com- partment syndrome (ACS). Despite this, some patients with these temporary abdominal dressings will go

  14. [The early abdominal pregnancy--case report].

    PubMed

    Posadzka, Ewa; Jach, Robert; Pity?ski, Kazimierz; Matyszkiewicz, Anna

    2014-01-01

    The abdominal ectopic pregnancies are 1-1.4% of all ectopic pregnancies. In this article we presents the case of 27-year-old patient in early abdominal pregnancy, situated in parietal peritoneum. This case justifies the need to take into account possibility of abdominal pregnancy in case of suspicion of ectopic pregnancy. PMID:25344980

  15. Multiple giant intra abdominal lipomas: A rare presentation

    PubMed Central

    Kshirsagar, Ashok Y.; Nangare, Nitin R.; Gupta, Vaibhav; Vekariya, Mayank A.; Patankar, Ritvij; Mahna, Abhishek; Wader, J.V.

    2014-01-01

    INTRODUCTION Solitary or multiple lipomas, composed of mature fat, represents by far the most common benign mesenchymal neoplasm occurring throughout the whole body, but they rarely originate in the intestinal mesentery. PRESENTATION OF CASE A 60-year-old male presented with left sided abdominal distension and pain since 4 months, ultrasonography and computerized tomography abdomen was suggestive of multiple well-defined fat density lesions in the lower abdomen and pelvis. USG guided fine needle aspiration cytology was conclusive of a spindle cell lesion. Exploratory laparotomy was performed and multiple major fat tissue swellings were excised. Histopathology confirmed it to be spindle cell type of lipoma. DISCUSSION Because of the silent nature the exact prevalence of lipomas is unknown. It can arise in any location in which fat is normally present, reported intra abdominal lipomas have been very rare. Clinical manifestations depend on the size and location of the growth. In most patients, symptoms are few or absent. USG and CT scan abdomen are used for the diagnosis. Complete surgical excision being the only treatment. CONCLUSION Intra abdominal lipoma is a very rare entity, and many cases might be ignored due to their silent nature. They might or might not present with any symptoms. Complete surgical excision being the only treatment, with a very good prognosis. PMID:24862028

  16. Massive Charcot spinal disease deformity in a patient presenting with increasing abdominal girth and discomfort. Case report.

    PubMed

    Bishop, Frank S; Dailey, Andrew T; Schmidt, Meic H

    2010-03-01

    Charcot spinal disease is a destructive degenerative process involving the vertebrae and surrounding discs, resulting from repetitive microtrauma in patients who have decreased joint protective mechanisms due to loss of deep pain and proprioceptive sensation. The typical presentation of the disease is back pain and progressive spinal instability and deformity. The authors report an unusual case of massive Charcot spinal disease deformity in a patient presenting with increasing abdominal girth and discomfort. PMID:20192662

  17. Advanced abdominal pregnancy: a study of 13 consecutive cases seen in 1993 and 1994 at Komfo Anokye Teaching Hospital, Kumasi, Ghana.

    PubMed

    Opare-Addo, H S; Deganus, S

    2000-04-01

    Thirteen cases of advanced abdominal pregnancy (AAP) managed at the Komfo Anokye Teaching Hospital (KATH), Kumasi, Ghana, over a two-year period (1993-1994) are presented. An incidence ratio of one advanced abdominal pregnancy to 1,320 deliveries occurred during this period. The ratio of advanced abdominal pregnancy to ectopic pregnancy was 1:43.7. The perinatal mortality rate and maternal case fatality rates were 69.6% and 15.3% respectively. Recurrent abdominal pains in the gravid patient with abnormal fetal lie and prior history of tubal pregnancy and/or previous abdominal surgery were significant findings in the cases reviewed. These findings should, therefore, always prompt lucid and elaborate ultrasound examination of a pregnancy to exclude abdominal pregnancy. PMID:11000706

  18. When Sex Is Painful

    MedlinePLUS

    How common is painful sex? Pain during intercourse is very common—nearly 3 out of 4 women have pain during intercourse at some time during ... a long-term problem. What causes pain during sex? Pain during sex may be a sign of ...

  19. Shoulder Pain COMMON CAUSES

    E-print Network

    Virginia Tech

    Shoulder Pain COMMON CAUSES: Shoulder injury or pain may be triggered by a specific event those required in swimming, tennis, baseball, and football can lead to shoulder pain. These OVER USE labor can lead to shoulder pain over time. Long term shoulder problems are more likely when pain

  20. Neuroanatomy of lower gastrointestinal pain disorders

    PubMed Central

    Vermeulen, Wim; De Man, Joris G; Pelckmans, Paul A; De Winter, Benedicte Y

    2014-01-01

    Chronic abdominal pain accompanying intestinal inflammation emerges from the hyperresponsiveness of neuronal, immune and endocrine signaling pathways within the intestines, the peripheral and the central nervous system. In this article we review how the sensory nerve information from the healthy and the hypersensitive bowel is encoded and conveyed to the brain. The gut milieu is continuously monitored by intrinsic enteric afferents, and an extrinsic nervous network comprising vagal, pelvic and splanchnic afferents. The extrinsic afferents convey gut stimuli to second order neurons within the superficial spinal cord layers. These neurons cross the white commissure and ascend in the anterolateral quadrant and in the ipsilateral dorsal column of the dorsal horn to higher brain centers, mostly subserving regulatory functions. Within the supraspinal regions and the brainstem, pathways descend to modulate the sensory input. Because of this multiple level control, only a small proportion of gut signals actually reaches the level of consciousness to induce sensation or pain. In inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) patients, however, long-term neuroplastic changes have occurred in the brain-gut axis which results in chronic abdominal pain. This sensitization may be driven on the one hand by peripheral mechanisms within the intestinal wall which encompasses an interplay between immunocytes, enterochromaffin cells, resident macrophages, neurons and smooth muscles. On the other hand, neuronal synaptic changes along with increased neurotransmitter release in the spinal cord and brain leads to a state of central wind-up. Also life factors such as but not limited to inflammation and stress contribute to hypersensitivity. All together, the degree to which each of these mechanisms contribute to hypersensitivity in IBD and IBS might be disease- and even patient-dependent. Mapping of sensitization throughout animal and human studies may significantly improve our understanding of sensitization in IBD and IBS. On the long run, this knowledge can be put forward in potential therapeutic targets for abdominal pain in these conditions. PMID:24574773

  1. Hemoperitoneum in advanced abdominal pregnancy with a live baby: a case report

    PubMed Central

    2014-01-01

    Background Abdominal pregnancy is a rare condition which is usually missed during prenatal assessment particularly in settings lacking routine ultrasound surveillance. We report a case of abdominal pregnancy at 32 weeks, which is most likely to have been a tubal abortion with secondary implantation, leading to delivery of a healthy baby girl weighing 1.7 kg. Case presentation A 22-year-old woman, gravid 3 para 2 was referred to our centre from a district hospital with complaint of generalized abdominal pain and reduced fetal movements. Although the initial abdomino-pelvic ultrasound done at our centre was read as normal, there was subsequently a strong clinical suspicion of abdominal pregnancy, which was confirmed by a second ultrasound. The patient underwent laparotomy and was found to have an intact uterus with a viable fetus floating in the abdominal cavity without its amniotic sac and with hemoperitoneum of 1litre. The baby was extracted successfully; the placenta was found to be deeply implanted on the right cornual side extending to the fundus superiorly. Wedge resection of the cornual area and fundus was performed to remove the placenta. Intraoperatively, one unit of blood was transfused due to severe anemia prior to surgery. Both the mother and the baby were discharged home in good condition. Conclusion Abdominal pregnancy can be missed prenatally even when an imaging (ultrasound) facility is available. Emphasis should be placed on clinical assessment and thorough evaluation of patients. PMID:24564927

  2. Converting Potential Abdominal Hysterectomy to Vaginal One: Laparoscopic Assisted Vaginal Hysterectomy

    PubMed Central

    Shetty, Jyothi; Shanbhag, Asha

    2014-01-01

    Background. The idea of laparoscopic assisted vaginal hysterectomy (LAVH) is to convert a potential abdominal hysterectomy to a vaginal one, thus decreasing associated morbidity and hastening recovery. We compared intraoperative and postoperative outcomes between LAVH and abdominal hysterectomy, to find out if LAVH achieves better clinical results compared with abdominal hysterectomy. Material and methods. A total of 48 women were enrolled in the study. Finally 17 patients underwent LAVH (cases) and 20 underwent abdominal hysterectomy (controls). All surgeries were performed by a set of gynecologists with more or less same level of surgical experience and expertise. Results.None of the patients in LAVH required conversion to laparotomy. Mean operating time was 30 minutes longer in LAVH group as compared to abdominal hysterectomy group (167.06 + 31.97?min versus 135.25 + 31.72 min; P < 0.05). However, the mean blood loss in LAVH was 100?mL lesser than that in abdominal hysterectomy and the difference was found to be statistically significant (248.24 + 117.79?mL versus 340.00 + 119.86?mL; P < 0.05). Another advantage of LAVH was significantly lower pain scores on second and third postoperative days. Overall complications and postoperative hospital stay were not significantly different between the two groups. PMID:24729873

  3. Abdominal Cocoon Syndrome is a Rare Cause of Mechanical Intestinal Obstructions: A Report of Two Cases

    PubMed Central

    Solmaz, Ali; Tokoçin, Merve; Ar?c?, Sinan; Yi?itba?, Hakan; Yavuz, Erkan; Gülçiçek, Osman Bilgin; Erçetin, Canda?; Çelebi, Fatih

    2015-01-01

    Case series Patient: Male, 30 • Male, 47 Final Diagnosis: Abdominal cocoon syndrome Symptoms: Abdominal pain • nausea • vomiting Medication: — Clinical Procedure: Operation Specialty: Surgery Objective: Rare disease Background: Abdominal cocoon syndrome is also known in the literature as sclerosing peritonitis or sclerosing encapsulating peritonitis. It is characterized by total or partial encapsulation of abdominal viscera by a fibrous membrane. It has been reported mainly in adolescent women and the majority of the cases are of unknown etiology. Preoperative diagnosis is difficult and is usually established during laparotomy. We present 2 cases of acute mechanical intestinal obstruction caused by sclerosing encapsulating peritonitis. Case Report: Two male patients, ages 30 and 47, were admitted to our emergency department for mechanical intestinal obstruction. They were treated surgically and were diagnosed with abdominal cocoon syndrome. Conclusions: If abdominal cocoon syndrome is diagnosed pre-operatively and acute abdomen symptoms are not observed, surgery is unnecessary. If surgery is inevitable, membrane resection and bridotomy must be performed, as in our 2 cases. If resection is going to be performed, primary anastomosis is not recommended. Iatrogenic injuries that happened during the operation should not be immediately repaired, because creation of the stoma from the proximal part of the injury is recommended. PMID:25671606

  4. Internal abdominal hernia: Intestinal obstruction due to trans-mesenteric hernia containing transverse colon

    PubMed Central

    Crispín-Trebejo, Brenda; Robles-Cuadros, María Cristina; Orendo-Velásquez, Edwin; Andrade, Felipe P.

    2014-01-01

    INTRODUCTION Internal abdominal hernias are infrequent but an increasing cause of bowel obstruction still often underdiagnosed. Among adults its usual causes are congenital anomalies of intestinal rotation, postsurgical iatrogenic, trauma or infection diseases. PRESENTATION OF CASE We report the case of a 63-year-old woman with history of chronic constipation. The patient was hospitalized for two days with acute abdominal pain, abdominal distension and inability to eliminate flatus. The X-ray and abdominal computerized tomography scan (CT scan) showed signs of intestinal obstruction. Exploratory laparotomy performed revealed a trans-mesenteric hernia containing part of the transverse colon. The intestine was viable and resection was not necessary. Only the hernia was repaired. DISCUSSION Internal trans-mesenteric hernia constitutes a rare type of internal abdominal hernia, corresponding from 0.2 to 0.9% of bowel obstructions. This type carries a high risk of strangulation and even small hernias can be fatal. This complication is specially related to trans-mesenteric hernias as it tends to volvulize. Unfortunately, the clinical diagnosis is rather difficult. CONCLUSION Trans-mesenteric internal abdominal hernia may be asymptomatic for many years because of its nonspecific symptoms. The role of imaging test is relevant but still does not avoid the necessity of exploratory surgery when clinical features are uncertain. PMID:24880799

  5. Systematic review of family functioning in families of children and adolescents with chronic pain

    PubMed Central

    Lewandowski, Amy S.; Palermo, Tonya M.; Stinson, Jennifer; Handley, Susannah; Chambers, Christine T.

    2010-01-01

    Disturbances in family functioning have been identified in youth with chronic pain and are associated with worse child physical and psychological functioning. Assessment measures of family functioning used in research and clinical settings vary. This systematic review summarizes studies investigating relationships among family functioning, pain and pain-related disability in youth with chronic pain. Sixteen articles were reviewed. All studies were cross-sectional, seven utilized between-group comparisons (chronic pain versus healthy/control) and twelve examined within-group associations among family functioning, pain and/or pain-related disability. Studies represented youth with various pain conditions (e.g., headache, abdominal pain, fibromyalgia) aged 6 – 20 years. Findings revealed group differences in family functioning between children with chronic pain and healthy controls in five of seven studies. Significant associations emerged among family variables and pain-related disability in six of nine studies with worse family functioning associated with greater child disability; relationships between family functioning and children’s pain were less consistent. Different patterns of results emerged depending on family functioning measure used. Overall, findings showed that families of children with chronic pain generally have poorer family functioning than healthy populations, and that pain-related disability is more consistently related to family functioning than pain intensity. PMID:21055709

  6. Pain drawings in somatoform-functional pain

    PubMed Central

    2012-01-01

    Background Pain drawings are a diagnostic adjunct to history taking, clinical examinations, and biomedical tests in evaluating pain. We hypothesized that somatoform-functional pain, is mirrored in distinctive graphic patterns of pain drawings. Our aim was to identify the most sensitive and specific graphic criteria as a tool to help identifying somatoform-functional pain. Methods We compared 62 patients with somatoform-functional pain with a control group of 49 patients with somatic-nociceptive pain type. All patients were asked to mark their pain on a pre-printed body diagram. An investigator, blinded with regard to the patients’ diagnoses, analyzed the drawings according to a set of numeric or binary criteria. Results We identified 13 drawing criteria pointing with significance to a somatoform-functional pain disorder (all p-values???0.001). The most specific and most sensitive criteria combination for detecting somatoform-functional pain included the total number of marks, the length of the longest mark, and the presence of symmetric patterns. The area under the ROC-curve was 96.3% for this criteria combination. Conclusion Pain drawings are an easy-to-administer supplementary technique which helps to identify somatoform-functional pain in comparison to somatic-nociceptive pain. PMID:23256679

  7. Growing Pains (For Parents)

    MedlinePLUS

    ... Lessons? Visit KidsHealth in the Classroom What Other Parents Are Reading Measles: What to Know Vaccines: FAQs ... Precautions Checkups: What to Expect Growing Pains KidsHealth > Parents > General Health > Aches, Pains & Injuries > Growing Pains Print ...

  8. What Is Chronic Pain?

    MedlinePLUS Videos and Cool Tools

    ... Chronic Pain Medications & Treatments The Art of Pain Management What We Have Learned Going to the ER Communication Tools Pain Management Programs Videos Resources Glossary FAQs Surveys September is ...

  9. American Pain Society

    MedlinePLUS

    ... From the APS Newsroom Current research in The Journal of Pain discuss the latest in therapeutic opioids, chronic headaches, chronic neck pain and pain education. Read More » Posted February 16, 2015 Clinical Trial ...

  10. [A case of abdominal wall actinomycosis].

    PubMed

    Kim, Kyung Hoon; Lee, Jin Soo; Cho, Hyeong Jun; Choi, Seung Bong; Cheung, Dae Young; Kim, Jin Il; Lee, In Kyu

    2015-04-25

    Actinomycosis is a chronic suppurative granulomatous infectious disease caused by actinomyces species that is characterized by formation of characteristic clumps called as sulfur granules. Abdominal actinomycosis is a rare disease and is often difficult to diagnose before operation. Abdominal actinomycosis infiltrating into the abdominal wall and adhering to the colon is even rarer. Most abdominal actinomycosis develops after operation, trauma or inflammatory bowel disease, and is also considered as an opportunistic infection in immunocompromised patient with underlying malignancy, diabetes mellitus, human immunodefidiency virus infection, etc. Actinomycosis is diagnosed based on histologic demonstration of sulfur granules in surgically resected specimen or pus, and treatment consists of long-term penicillin based antibiotics therapy with or without surgical resection. Herein, we report an unusual case of abdominal wall actinomycosis which developed in a patient after acupuncture and presented as abdominal wall mass that was first mistaken for abdominal wall invasion of diverticulum perforation. PMID:25896158

  11. Pain syndromes in children

    Microsoft Academic Search

    David D. Sherry

    2000-01-01

    The pediatric rheumatologist cares for children who may have a wide variety of causes of musculoskeletal pain. These include\\u000a such diverse conditions as arthritis, low-back pain, hypermobility, metabolic bone pain, and amplified pain syndromes such\\u000a as complex regional pain syndrome and fibromyalgia. This review examines the recent literature on these and other conditions\\u000a causing musculoskeletal pain in children and adolescents.

  12. Pain Management: Post-Amputation Pain

    MedlinePLUS

    Pain Management Post-Amputation Pain Volume 8 · Issue 2 · March/April 1998 Text size Larger text Smaller text Java ... of the most frequently asked questions. Ideas about management are one of the frequent topics of conversation ...

  13. Abdominal aortic aneurysms in children

    Microsoft Academic Search

    A. J. W. Millar; R. D. Gilbert; R. A. Brown; E. J. Immelman; D. A. Burkimsher; S. Cywes

    1996-01-01

    Abdominal aortic aneurysms are rare in children. Causes include mycotic aneurysms, vasculitides (eg, Takayasu's arteritis), connective tissue diseases (eg, Marfan's syndrome, Ehlers-Danlos syndrome, and tuberous sclerosis) and traumatic false aneurysms. Four cases are described. Case 1 was a 12-year-old boy who presented with an acute unheralded rupture of the subdiaphragmatic aorta accompanied by lower limb paralysis and ischemia. Attempted repair

  14. Significant Determinants of Mouse Pain Behaviour

    PubMed Central

    Minett, Michael S.; Eijkelkamp, Niels; Wood, John N.

    2014-01-01

    Transgenic mouse behavioural analysis has furthered our understanding of the molecular and cellular mechanisms underlying damage sensing and pain. However, it is not unusual for conflicting data on the pain phenotypes of knockout mice to be generated by reputable groups. Here we focus on some technical aspects of measuring mouse pain behaviour that are often overlooked, which may help explain discrepancies in the pain literature. We examined touch perception using von Frey hairs and mechanical pain thresholds using the Randall-Selitto test. Thermal pain thresholds were measured using the Hargreaves apparatus and a thermal place preference test. Sodium channel Nav1.7 knockout mice show a mechanical deficit in the hairy skin, but not the paw, whilst shaving the abdominal hair abolished this phenotype. Nav1.7, Nav1.8 and Nav1.9 knockout mice show deficits in noxious mechanosensation in the tail, but not the paw. TRPA1 knockout mice, however, have a loss of noxious mechanosensation in the paw but not the tail. Studies of heat and cold sensitivity also show variability depending on the intensity of the stimulus. Deleting Nav1.7, Nav1.8 or Nav1.9 in Nav1.8-positive sensory neurons attenuates responses to slow noxious heat ramps, whilst responses to fast noxious heat ramps are only reduced when Nav1.7 is lost in large diameter sensory neurons. Deleting Nav1.7 from all sensory neurons attenuates responses to noxious cooling but not extreme cold. Finally, circadian rhythms dramatically influence behavioural outcome measures such as von Frey responses, which change by 80% over the day. These observations demonstrate that fully characterising the phenotype of a transgenic mouse strain requires a range of behavioural pain models. Failure to conduct behavioural tests at different anatomical locations, stimulus intensities, and at different points in the circadian cycle may lead to a pain behavioural phenotype being misinterpreted, or missed altogether. PMID:25101983

  15. Radiology of blunt abdominal trauma.

    PubMed

    Kurtzman, R S

    1977-02-01

    Blunt abdominal trauma can produce injury to any of the intra-abdominal organs. While diagnostic studies may be necessary to help determine the most appropriate therapy, all these procedures take time, which in some instances can be better used to treat the patient actively. The condition of the patient and the clinical findings take precedence in the handling of the injured patient. Certain skeletal injuries are often a first clue and can help focus further investigations. Plain films and regular contrast examinations are adequate to evaluate most intra-abdominal injuries. When time is available, a variety of other radiologic techniques are available in most hospitals. Nuclear imaging is of considerable value in studying the liver, spleen, and kidneys. Thus far, ultrasound techniques have left much to be desired although theoretically of considerable potential. Angiography can be of great diagnostic and potentially of some therapeutic value. No diagnostic test beats a good history and careful examination. Radiologic studies, ideally, should be done to confirm a clinical suspicion, not just for the sake of "completeness." PMID:558659

  16. [Hypoplasia of the descending thoracic and abdominal aorta in Williams-Beuren syndrome].

    PubMed

    Romer, G Schenk; Weishaupt, D; Koppensteiner, R

    2005-05-01

    Hypoplasia of the descending thoracic and abdominal aorta is a very rare condition and its etiology is poorly understood. Associations with congenital and acquired disorders have been reported. In this article we present the case of a 24-year-old woman with hypoplasia of the thoracic and abdominal aorta and Williams-Beurensyndrome. This rare syndrome is attributed to deletions of genes on chromosome 7, among other the elastin-gene, and is characterized by cardiovascular anomalies, dysmorph facial features and mental retardation. The patient presented with a history of severe hypertension and recurrent abdominal pain since childhood. Diagnosis was established by duplex-sonography and magnetic resonance angiography. The patient was treated by an aortoaortic bypass from the ascending to the infrarenal aorta with reinsertion of the visceral and the right renal arteries. It is essential to recognize the condition early to withhold high morbidity and mortality resulting from long standing severe hypertension. PMID:15968897

  17. The effects of preoperative intravenous acetaminophen in patients undergoing abdominal hysterectomy

    Microsoft Academic Search

    Young-Eun MoonYoon-Ki; Yoon-Ki Lee; Jaemin Lee; Dong-Eon Moon

    Purpose  Although intravenous acetaminophen is commonly used for the management of postoperative pain, very limited evidence supports\\u000a the usefulness of preoperative administration. The aim of this study was to determine the analgesic effect of preoperative\\u000a acetaminophen on opioid consumption, pain scores, and side effects in patients receiving an elective abdominal hysterectomy.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  A randomized, double-blinded, placebo-controlled clinical trial was performed in 76

  18. [Appendiceal mucocele as differential diagnostic problem of palpable mass in the right lower abdominal region].

    PubMed

    Szalóki, Eszter Aliz; Vereczkey, Ildikó; Pete, Imre

    2013-09-01

    Appendiceal mucocele is a rare disease (0.2-0.3% of all appendectomies) and it is defined as abnormal accumulation of mucoid material in the appendiceal lumen. Almost half of the patients are asymptomatic. The most common clinical manifestation is pain and palpable mass in the right iliac fossa, which is difficult to differentiate from the malignant or benign adnexal masses. By presenting our three cases, we would like to draw attention to the diagnostic difficulties of the pain and palpable mass in the right lower abdominal region. PMID:24107827

  19. Peripheral Pain Mechanisms in Chronic Widespread Pain

    PubMed Central

    Staud, Roland

    2011-01-01

    Clinical symptoms of chronic widespread pain (CWP) conditions including fibromyalgia (FM), include pain, stiffness, subjective weakness, and muscle fatigue. Muscle pain in CWP is usually described as fluctuating and often associated with local or generalized tenderness (hyperalgesia and/or allodynia). This tenderness related to muscle pain depends on increased peripheral and/or central nervous system responsiveness to peripheral stimuli which can be either noxious (hyperalgesia) or non-noxious (allodynia). For example, patients with muscle hyperalgesia will rate painful muscle stimuli higher than normal controls, whereas patients with allodynia may perceive light touch as painful, something that a “normal” individual will never describe as painful. The pathogenesis of such peripheral and/or central nervous system changes in CWP is unclear, but peripheral soft tissue changes have been implicated. Indirect evidence from interventions that attenuate tonic peripheral nociceptive impulses in patients with CWP syndromes like FM suggest that overall FM pain is dependent on peripheral input. More importantly, allodynia and hyperalgesia can be improved or abolished by removal of peripheral impulse input. Another potential mechanism for CWP pain is central disinhibition. However, this pain mechanism also depends on tonic impulse input, even if only inadequately inhibited. Thus a promising approach to understanding CWP is to determine whether abnormal activity of receptors in deep tissues is fundamental to the development and maintenance of this chronic pain disorder. Conclusions Most CWP patients present with focal tissue abnormalities including myofascial trigger points, ligamentous trigger points, or osteoarthritis of the joints and spine. While not predictive for the development of CWP these changes nevertheless represent important pain generators that may initiate or perpetuate chronic pain. Local chemical mediators, including lactic acid, ATP, and cytokines seem to play an important role in sensitizing deep tissue nociceptors of CWP patients. Thus the combination of peripheral impulse input and increased central pain sensitivity may be responsible for wide-spread chronic pain disorders including FM. PMID:22094192

  20. Abdominal infections in patients with acute leukaemia: a prospective study applying ultrasonography and microbiology.

    PubMed

    Gorschlüter, Marcus; Marklein, Günter; Höfling, Katja; Clarenbach, Ricarda; Baumgartner, Stefanie; Hahn, Corinna; Ziske, Carsten; Mey, Ulrich; Heller, Ricarda; Eis-Hübinger, Anna Maria; Sauerbruch, Tilman; Schmidt-Wolf, Ingo G H; Glasmacher, Axel

    2002-05-01

    A prospective study of 62 chemotherapy-induced neutropenic episodes in patients with acute leukaemia was conducted to determine the incidence and causes of abdominal infections, and to assess the diagnostic value of the combined use of ultrasonography (US) and microbiology. Each patient underwent US of liver, gallbladder and complete bowel before chemotherapy, on days 2-4 after the end of chemotherapy and in cases of fever, diarrhoea or abdominal pain. US was combined with a standardized clinical examination and a broad spectrum of microbiological investigations. From January to August 2001, 243 US examinations were performed. The overall incidence of abdominal infectious diseases was 17.7% (11 out of 62, 95% confidence interval (CI): 9-29%). Four patients (6.5%) developed neutropenic enterocolitis; two of them died, two survived. Bowel wall thickening (BWT) > 4 mm in these four patients ranged from 5.8 to 23.6 mm and was detected only in one patient with mucositis. In three other patients (4.8%) Clostridium difficile, and in one patient (1.6%) Campylobacter jejuni, caused enterocolitis without BWT. Cholecystitis was diagnosed in three patients (4.8%) and hepatic candidiasis was strongly suspected in one patient. Abdominal infections caused by gastroenteritis viruses, cytomegalovirus (CMV) or Cryptosporidium were not observed. We conclude that in neutropenic patients with acute leukaemia receiving chemotherapy: (i) BWT is not a feature of chemotherapy-induced mucositis and should therefore be considered as sign of infectious enterocolitis; (ii) viruses, classic bacterial enteric pathogens (Salmonella, Shigella, Yersinia, Campylobacter, Aeromonas, Vibrio subsp., enterohaemorrhagic Escherichia coli) and Cryptosporidium have a very low incidence; and (iii) abdominal infections may be underestimated when US is not used in every patient with abdominal pain. PMID:11972517

  1. Classification of biomaterials and their related complications in abdominal wall hernia surgery

    Microsoft Academic Search

    P. K. Amid

    1997-01-01

    Summary  The value of the use of biomaterials for the repair of abdominal wall hernias is gaining increasing recognition. The use of\\u000a synthetic mesh to achieve a tension-free repair has resulted in a significant reduction in postoperative pain, in length of\\u000a the recovery period, and in the number of recurrences. However, certain physical properties of biomaterials can lead to undesirable\\u000a consequences.

  2. The effect of intravenous ketorolac given intraoperatively versus postoperatively on outcome from gynecologic abdominal surgery

    Microsoft Academic Search

    Philip Balestrieri; Gary Simmons; Douglas Hill; Jean Brown; Alice Jackson; Sorin J. Brull; Thomas J. Maneatis; Arna Shefrin; Lincoln Bynum; Dorene A. O'Hara

    1997-01-01

    Study Objectives: To examine the effect of timing of an intravenous (IV) dose (intraoperative vs. postoperative) of ketorolac tromethamine on pain scores and overall outcome after total abdominal hysterectomy (TAH) and myomectomy.Design: Prospective, randomized, placebo-controlled study.Patients: 248 ASA physical status I and II adult female patients scheduled for elective hysterectomy or myomectomy.Interventions: General anesthesia was administered that consisted of thiopental

  3. Clinical detection of abdominal aortic aneurysm in a 74-year-old man in chiropractic practice

    PubMed Central

    de Boer, Nathan J.; Knaap, Simone F.C.; de Zoete, Annemarie

    2010-01-01

    Objective The purpose of this article is to present a case of abdominal aortic aneurysm to illustrate its clinical detection through history and physical examination and the importance of this condition to the chiropractic clinical setting. Clinical Features A 74-year-old retired man consulted a doctor of chiropractic for chronic low back pain. The history and physical examination confirmed chronic sacroiliac and a lumbar facet dysfunction. After 5 weeks, the patient stated he had stomach cramps. After this, a more thorough abdominal examination was done. The doctor of chiropractic detected an enlarged pulsatile mass upon abdominal palpation. Intervention and outcome The patient was sent to the cardiologist and had successful surgery within weeks. Conclusion An abdominal aortic aneurysm has specific symptoms and associated risk factors. If known risk factors are present, a clinical examination needs to be carried out, even though sensitivity of the clinical examination may be low. It should be a differential diagnosis in every male patient older than 50 years with low back pain. In case of suspicion, the patient should be referred for advanced imaging. PMID:21629398

  4. Interventional pain treatments for cancer pain.

    PubMed

    Christo, Paul J; Mazloomdoost, Danesh

    2008-09-01

    Cancer pain is prevalent and often multifactorial. For a segment of the cancer pain population, pain control remains inadequate despite full compliance with the WHO analgesic guidelines including use of co-analgesics. The failure to obtain acceptable pain or symptom relief prompted the inclusion of a fourth step to the WHO analgesic ladder, which includes advanced interventional approaches. Interventional pain-relieving therapies can be indispensable allies in the quest for pain reduction among cancer patients suffering from refractory pain. There are a variety of techniques used by interventional pain physicians, which may be grossly divided into modalities affecting the spinal canal (e.g., intrathecal or epidural space), called neuraxial techniques and those that target individual nerves or nerve bundles, termed neurolytic techniques. An array of intrathecal medications are infused into the cerebrospinal fluid in an attempt to relieve refractory cancer pain, reduce disabling adverse effects of systemic analgesics, and promote a higher quality of life. These intrathecal medications include opioids, local anesthetics, clonidine, and ziconotide. Intrathecal and epidural infusions can serve as useful methods of delivering analgesics quickly and safely. Spinal delivery of drugs for the treatment of chronic pain by means of an implantable drug delivery system (IDDS) began in the 1980s. Both intrathecal and epidural neurolysis can be effective in managing intractable cancer-related pain. There are several sites for neurolytic blockade of the sympathetic nervous system for the treatment of cancer pain. The more common sites include the celiac plexus, superior hypogastric plexus, and ganglion impar. Today, interventional pain-relieving approaches should be considered a critical component of a multifaceted therapeutic program of cancer pain relief. PMID:18837908

  5. Sickle Cell Pain

    MedlinePLUS

    ... patient’s life. Folic acid prevents severe anemia in sickle cell disease. Other studies have suggested that the more severe and painful ... chance of long-lasting PHN pain. Also, some studies have concluded that people who do not ... Treatment for sickle cell pain The terrible pain of a sickle ...

  6. Thai perspectives on pain.

    PubMed

    Mongkhonthawornchai, Siriporn; Sangchart, Bumpenchit; Sornboon, Ariya; Chantarasiri, Jongkolnee

    2013-09-01

    This qualitative research aimed to study the meaning, the characteristics, and the dimensions of pain from a Thai point of view. It was conducted under the research project on the development of the quality of pain management for people in the hospital. The subjects were 62 patients, experiencing pain and receiving treatment in 4 hospitals in northeast Thailand. Data were analyzed through content analysis. The findings included: 1) concept from experience of pain, perceived pain as suffering physically and psychologically, 2) different characteristics between acute and chronic pain, 3) four levels of pain intensity: mild, moderate, high and severe, 4) pain effects on four dimensions: physical, psychological, behavioral and societal (family-social-economy), 5) two factors related to pain: alleviating factor and predisposing factor, and 6) pain management relies on beliefs, culture and religion i.e. good deeds in Buddhism affected six dimensions: physical, psychological, social, spiritual, treatment seeking and asking health personnel for help. The results of the present study revealed the influence of culture beliefs on the meaning of pain, pain characteristics, and the effects of pain as well as pain management in terms of cultural contexts. The findings may be implemented for the development of pain assessment and the model development of pain management more appropriately according to cultural contexts. PMID:24386747

  7. Radiological evaluation of internal abdominal hernias.

    PubMed

    Selçuk, Do?an; Kantarci, Fatih; O?üt, Gündüz; Korman, U?ur

    2005-06-01

    An internal abdominal herniation is the protrusion of a viscus through a normal or abnormal mesenteric or peritoneal aperture. Internal abdominal herniations can either be acquired through a trauma or surgical procedure, or constitutional and related to congenital peritoneal defects. Paraduodenal hernias are the most common type of internal abdominal hernias, accounting for over one-half of reported cases, and thus are a significant clinical entity. Other internal hernias include pericecal, transmesenteric, transomental, intersigmoid, supravesical hernias and herniation through the foramen of Winslow. Because internal abdominal herniations are rare, their diagnosis remains a challenge for both the clinician and the radiologist. Symptoms of internal abdominal herniations are nonspecific. We present our experience with the radiological evaluation of internal abdominal herniations and review the main radiologic findings on barium as well as computed tomography studies. PMID:16252193

  8. Abdominal Aortic Aneurysm Complicated by Intestinal Malrotation

    PubMed Central

    Okazaki, Jin; Ishida, Masaru; Kodama, Akio; Mii, Shinsuke

    2015-01-01

    Intestinal malrotation (IM) is an anomaly of fetal intestinal rotation that usually presents in the first month of life; it is rare for malrotaion to present in adulthood. Furthermore, the presentation of IM in conjunction with Abdominal aortic aneurysm is extremely rare and may require consideration with respect to the surgical approach and exposure of the abdominal aorta. We herein report a case of an abdominal aortic aneurysm complicated by intestinal malrotation. PMID:25848429

  9. The Abdominal Compartment Syndrome Following Aortic Surgery

    Microsoft Academic Search

    I. M Loftus; M. M Thompson

    2003-01-01

    Background: multi-organ failure is a leading cause of death following aneurysm surgery, especially in the emergency setting. Intra-abdominal hypertension is an important factor in the development of multi-organ failure. Prevention, early recognition and prompt treatment of abdominal hypertension and the abdominal compartment syndrome may reduce mortality following aneurysm surgery.Methods: a descriptive review of the literature from a Medline search.Results and

  10. Surgical Treatment for Chronic Pelvic Pain

    PubMed Central

    1998-01-01

    The source of chronic pelvic pain may be reproductive organ, urological, musculoskeletal - neurological, gastrointestinal, or myofascial. A psychological component almost always is a factor, whether as an antecedent event or presenting as depression as result of the pain. Surgical interventions for chronic pelvic pain include: 1) resection or vaporization of vulvar/vestibular tissue for human papillion virus (HPV) induced or chronic vulvodynia/vestibulitis; 2) cervical dilation for cervix stenosis; 3) hysteroscopic resection for intracavitary or submucous myomas or intracavitary polyps; 4) myomectomy or myolysis for symptomatic intramural, subserosal or pedunculated myomas; 5) adhesiolysis for peritubular and periovarian adhesions, and enterolysis for bowel adhesions, adhesiolysis for all thick adhesions in areas of pain as well as thin ahesions affecting critical structures such as ovaries and tubes; 6) salpingectomy or neosalpingostomy for symptomatic hydrosalpinx; 7) ovarian treatment for symptomatic ovarian pain; 8) uterosacral nerve vaporization for dysmenorrhea; 9) presacral neurectomy for disabling central pain primarily of uterine but also of bladder origin; 10) resection of endometriosis from all surfaces including removal from bladder and bowel as well as from the rectovaginal septal space. Complete resection of all disease in a debulking operation is essential; 11) appendectomy for symptoms of chronic appendicitis, and chronic right lower quadrant pain; 12) uterine suspension for symptoms of collision dyspareunia, pelvic congestion, severe dysmenorrhea, cul-desac endometriosis; 13) repair of all hernia defects whether sciatic, inguinal, femoral, Spigelian, ventral or incisional; 14) hysterectomy if relief has not been achieved by organ-preserving surgery such as resection of all endometriosis and presacral neurectomy, or the central pain continues to be disabling. Before such a radical step is taken, MRI of the uterus to confirm presence of adenomyosis may be helpful; 15) trigger point injection therapy for myofascial pain and dysfunction in pelvic and abdominal muscles. With application of all currently available laparoscopic modalities, 80% of women with chronic pelvic pain will report a decrease of pain to tolerable levels, a significant average reduction which is maintained in 3-year follow-up. Individual factors contributing to pain cannot be determined, although the frequency of endometriosis dictates that its complete treatment be attempted. The beneficial effect of uterosacral nerve ablation may be as much due to treatment of occult endometriosis in the uterosacral ligaments as to transection of the nerve fibers themselves. The benefit of the presacral neurectomy appears to be definite but strictly limited to midline pain. Appendectomy, herniorraphy, and even hysterectomy are all appropriate therapies for patients with chronic pelvic pain. Even with all laparoscopic procedures employed, fully 20% of patients experience unsatisfactory results. In addition, these patients are often depressed. Whether the pain contributes to the depression or the depression to the pain is irrelevant to them. Selected referrals to an integrated pain center with psychologic assistance together with judicious prescription of antidepressant drugs will likely benefit both women who respond to surgical intervention and those who do not. A maximum surgical effort must be expended to resect all endometriosis, restore normal pelvic anatomy, resect nerve fibers, and treat surgically accessible disease. In addition, it is important to provide patients with chronic pelvic pain sufficient psychologic support to overcome the effects of the condition, and to assist them with underlying psychologic disorders. PMID:9876726

  11. Abdominal Wall Abscess due to Acute Perforated Sigmoid Diverticulitis: A Case Report with MDCT and US Findings

    PubMed Central

    Vasileios, Rafailidis; Anna, Gavriilidou; Christos, Liouliakis; Asimina, Tsimitri; Sofia, Paschaloudi; Vasiliki, Karadimou

    2013-01-01

    Perforation of the inflamed diverticula is a common diverticulitis complication. It usually leads to the formation of a local abscess. In some rare cases, the inflammatory process may spread towards extra-abdominal sites like the anterior or posterior abdominal wall or the thigh and form an abscess in these sites. We present the case of a 73-year-old man with a history of pain at the lower left quadrant of the abdomen for 20 days and a visible mass in this site. Ultrasonography and computed tomography revealed this mass to be an abscess of the abdominal wall which had been formed by the spread of ruptured sigmoid diverticulitis by continuity of tissue through the lower left abdominal wall. Local drainage of the abscess was performed and the patient was discharged after alleviation of symptoms and an uneventful course. We also discuss causes of abdominal wall abscesses along with the possible pathways by which an intra-abdominal abscess could spread outside the abdominal cavity. PMID:24386584

  12. Chronic pain after caesarean delivery: an Australian cohort.

    PubMed

    Liu, T T; Raju, A; Boesel, T; Cyna, A M; Tan, S G M

    2013-07-01

    We investigated the incidence of and risk factors for persistent pain after caesarean delivery. Over a 12-month period, women having caesarean delivery were recruited prospectively at an Australian tertiary referral centre. Demographic, anaesthetic and surgical data were collected and at 24 hour follow-up, women were assessed for immediate postoperative pain and preoperative expectations of pain. Long-term telephone follow-up was conducted at two and 12 months postoperatively. Complete data were obtained from 426 of 469 women initially recruited (90.6%). The incidence of persistent pain at the abdominal wound at two months was 14.6% (n=62) but subsequently reduced to 4.2% (n=18) at 12 months. At two months, 33 patients (7.8%) experienced constant or daily pain. At 12 months, five patients (1.1%) continued to have constant or daily pain which was mild. There was no apparent increase in incidence of persistent pain associated with general versus regional anaesthesia (relative risk [RR] 0.89, 95% confidence interval [CI] 0.49 to 1.6); emergency vs elective procedure (RR 0.65, 95% CI 0.39 to 1.07); higher acute pain scores (RR 1.1, 95% CI 0.69 to 1.75); or history of previous caesarean delivery (RR 0.81, 95% CI 0.50 to 1.33). Persistent pain, usually of a mild nature, is reported by some women two months after their caesarean delivery, but by 12 months less than 1% of women had pain requiring analgesia or affecting mood or sleep. All declined a pain clinic review. Clinicians and patients can be reassured that caesarean delivery is unlikely to lead to severe persistent pain in the long-term. PMID:23808509

  13. The Effect of Postoperative Hyperbaric Oxygen Treatment on Intra-Abdominal Adhesions in Rats

    PubMed Central

    Chen, Ming-Jenn; Chen, Tzu-Yu; Cheng, Ya-Min; Hsu, Yi-Chiang

    2012-01-01

    Abdominal adhesions, whether caused by peritoneal trauma, radiation, infection, or a congenital condition, are associated with a wide range of complications. These complications include chronic abdominal or pelvic pain, infertility, and adhesive small bowel obstruction. Such adhesions render re-operation difficult, with attendant risks of inadvertent enterostomy and increased operation time. The purpose of this study was to investigate the potential of hyperbaric oxygen (HBO) therapy in the prevention of abdominal adhesions in an experimental animal study. A laparotomy was performed on Wistar rats to induce the formation of adhesions on the cecum and the intra-abdominal area (1 × 2 cm). A superficial layer of the underlying muscle from the right abdominal wall was also shaved and prepared for aseptic surgery. The rats were divided into four groups according to the duration of HBO therapy; five additional groups were designated according to the conditions of HBO therapy. When the rats were evaluated according to adhesion area and grade, a statistically significant difference was observed between the control and HBO treatment groups (p < 0.005). Results from this study suggest that HBO treatment could reduce adhesion formation; and further suggest that HBO therapy may have therapeutic potential in the treatment of postoperative peritoneal adhesion. PMID:23202894

  14. Idiopathic sclerosing encapsulating peritonitis (abdominal cocoon) in adult male. A case report

    PubMed Central

    Al Ani, Amer Hashim; Al Zayani, Najah; Najmeddine, Mohammad; Jacob, Sunitha; Nair, Sunil

    2014-01-01

    INTRODUCTION Abdominal cocoon (sclerosing encapsulating peritonitis) (SEP) is a rare condition, mostly affecting adolescent girls living in tropical/subtropical region. Its etiology is unknown. It may cause acute or sub-acute intestinal obstruction. PRESENTATION OF CASE We report here a 39 year old male who complained of long standing colicky abdominal pain, with significant weight loss. Abdomen CT scan showed clumping of ileal loops at the level of umbilicus, with a thin capsule surrounding it. Laparoscopy revealed abdominal cocoon, biopsy of which showed dense hypocellular fibro-collagenous tissue with no neoplastic or granulomatous process. Excision of fibrous tissue and release of adhesions was done. Patient was symptoms free after five months follow up. DISCUSSION Abdominal exploration is usually needed for the diagnosis and treatment of abdominal cocoon. A thick fibrotic peritoneal wrapping of the bowel is usually found. Complete recovery is the result in majority of cases after surgical removal of the wrap causing the cocoon. CONCLUSION Primary sclerosing encapsulating peritonitis (cocoon abdomen) diagnosis needs a high index of suspicion, as signs and symptoms are nonspecific and imaging findings are not always conclusive. Careful excision of the accessory peritoneal sac and lysis of adhesions between bowels is the best treatment. Prognosis is generally good. PMID:25217877

  15. Temporary abdominal closure followed by definitive abdominal wall reconstruction of the open abdomen

    Microsoft Academic Search

    Thomas R. Howdieshell; Charles D. Proctor; Erez Sternberg; Jorge I. Cué; J. Sheppard Mondy; Michael L. Hawkins

    2004-01-01

    BackgroundInability to close the abdominal wall after laparotomy for trauma may occur as a result of visceral edema, retroperitoneal hematoma, use of packing, and traumatic loss of tissue. Often life-saving, decompressive laparotomy and temporary abdominal closure require later restoration of anatomic continuity of the abdominal wall.

  16. Abdominal atlas mapping in CT and MR volume images using a normalized abdominal coordinate system

    Microsoft Academic Search

    Hongkai Wang; Jing Bai; Yongxin Zhou; Yonghong Zhang

    2008-01-01

    In this paper, a normalized abdominal coordinate system is defined for abdominal atlas mapping in CT and MR volume images. This coordinate system is independent of both the abdomen size and the respiratory motion. A real-time atlas mapping algorithm based on this coordinate system is also proposed. The purpose of this algorithm is to provide initial positions for abdominal organ

  17. Abdominal Tumor in a 14-Year-Old Adolescent: Imperforate Hymen, Resulting in Hematocolpos—A Case Report and Review of the Literature

    PubMed Central

    Makris, George Marios; Macchiella, Doris; Vaidakis, Dennis; Chrelias, Charalampos; Battista, Marco Johannes; Siristatidis, Charalampos

    2015-01-01

    Background. Abdominal masses in female adolescents are uncommon. A rare cause of this condition is hematocolpos due to imperforate hymen. Case. We present a case of an unusually massive asymptomatic abdominal bulk in a 14-year-old female patient, who sought for medical advice after unusual abdominal pain lasting for few weeks. The patient was otherwise asymptomatic, apart from an unusual dramatic expansion of her abdominal wall during the last month. We describe the surgical management and the follow-up of the patient. Summary and Conclusion. Clinicians should keep in mind that an imperforate hymen can cause abdominal growth due to hematocolpos and include it in the differential diagnosis of such a clinical entity in female adolescents. 2D ultrasound is usually efficient for the confirmation of the diagnosis of hematocolpos, but 3D ultrasound is more accurate. Wide excision should be undertaken, as an initial approach, to avoid recurrence. PMID:25737786

  18. Neuraxial pain relief for intractable cancer pain

    Microsoft Academic Search

    Paul A. Sloan

    2007-01-01

    Most patients with cancer pain achieve good analgesia using traditional analgesics and adjuvant medications; however, an important\\u000a minority of patients (2% to 5%) suffers from severe and refractory cancer pain. For these individuals, spinal analgesics (intrathecal\\u000a or epidural) provide significant hope for pain relief over months or years of treatment to help improve quality of life. Spinal\\u000a analgesics have been

  19. Gender differences in pain.

    PubMed

    Dao, T T; LeResche, L

    2000-01-01

    A review of the literature on gender and clinical pain reveals a disproportionate representation of women receiving treatment for many pain conditions and suggests that women report more severe pain, more frequent pain, and pain of longer duration than do men. Gender differences in pain perception have also been extensively studied in the laboratory, and ratings of experimentally induced pain also show some sex disparity, with females generally reporting lower pain thresholds and tolerance than males. However, there is little consensus on whether these apparent differences reflect the way men and women respond to pain, differing social rules for the expression of pain, or biologic differences in the way noxious stimuli are processed. In this paper, our working hypothesis is that the higher prevalence of chronic orofacial pain in women is a result of sex differences in generic pain mechanisms and of as-yet unidentified factors unique to the craniofacial system. We will review the evidence concerning gender differences in the prevalence of pain conditions, with a focus on orofacial pain conditions. Evidence and hypotheses concerning biologic and psychosocial factors that could influence prevalence rates will also be discussed. PMID:11203754

  20. A rare tumor revealed by abdominal trauma: case presentation.

    PubMed

    Diaconu, Camelia Cristina; Arsene, Dorel; B?l?ceanu, Alice Lavinia; Barto?, Daniela

    2014-01-01

    Pseudomyxoma peritonei is a rare and poorly understood form of disease characterized by mucin deposits in the peritoneum. The term includes a broad range of neoplasms with different patterns of evolution, from benign to borderline or even to malignant lesions. The disease may be asymptomatic until advanced stages. We present the case of a 65-year-old patient who presented for pain in the right hemiabdomen, after a trauma by falling from small height. Abdominal imaging studies oriented the diagnosis to a traumatic disease. At laparotomy, a mucinous tumor attached to the right colon was discovered. The main particularity of the case is that the origin of the pseudomyxoma could not be identified. PMID:25329130

  1. The abdominal technetium scan (a decade of experience)

    SciTech Connect

    Cooney, D.R.; Duszynski, D.O.; Camboa, E.; Karp, M.P.; Jewett, T.C. Jr.

    1982-10-01

    Out of 270 children with gastrointestinal symptoms, the indications for technetium scanning were: gastrointestinal tract bleeding (165 patients), abdominal pain (99 patients) and a history of intussusception (6 patients). Thirty children had abnormal findings, while the remaining 240 patients had normal scans. Four of the 30 children with positive scans were not explored, while the others underwent laparotomy. Of the 26 operated patients, 12 (46%) had a Meckel's diverticulum. Nine patients (34%) had other pathologic lesions that were detected by the scan. Five had true false positives as no pathologic lesions were found. Of the 240 children with negative scans, 19 were eventually explored because of persistent symptoms or clinical findings. Two of these had a Meckel's diverticulum. Eleven had a negative exploration while six had other surgical lesions. Technitium scan should reliably detect around 80%-90% of Meckel's diverticula. It will also accurately exclude the diagnosis of Meckel's diverticulum in over 90% of patients.

  2. CT evaluation of complications of abdominal aortic surgery

    SciTech Connect

    Mark, A.; Moss, A.A.; Lusby, R.; Kaiser, J.A.

    1982-11-01

    The authors conducted a retrospective analysis of the CT findings in 29 consecutive patients being studied to detect complications of aortofemoral bypass surgery. Presenting symptoms included fever in 22 (76%), gastrointestinal bleeding in 2 (7%), a pulsating mass in 3 (10%), jaundice in 1 (3%), and back pain in 1 (3%). The complications observed most frequently were groin infection in 7 (24%), abdominal perigraft abscess in 11 (38%), pseudoaneurysm in 6 (21%), aorto-enteric fistula in 3 (10%), and lymphocystic hematoma in 3 (10%). There were no false negatives, and overall accuracy and sensitivity of CT in detecting complications was 100%. The authors recommend that CT be performed prior to angiography or surgery whenever an abscess, pseudoaneurysm, or aorto-enteric fistula is suspected.

  3. Managing your chronic back pain

    MedlinePLUS

    ... Society Low Back Pain Guideline Panel. Interventional therapies, surgery, and interdisciplinary rehabilitation for low back pain: an evidence-based clinical practice guideline from the American Pain Society. ...

  4. Chiropractic care for back pain

    MedlinePLUS

    ... Society Low Back Pain Guideline Panel. Interventional therapies, surgery, and interdisciplinary rehabilitation for low back pain: an evidence-based clinical practice guideline from the American Pain Society. ...

  5. Epidural injections for back pain

    MedlinePLUS

    ... Society Low Back Pain Guideline Panel. Interventional therapies, surgery, and interdisciplinary rehabilitation for low back pain: an evidence-based clinical practice guideline from the American Pain Society. ...

  6. Pediatric pain management.

    PubMed

    Lederhaas, G

    1997-01-01

    It is now recognized that from the newborn period onwards, children are capable of experiencing pain. This includes the premature infant. The challenge for healthcare providers is to incorporate methods of pain assessment and treatment into their daily practices. The child's understanding of pain closely follows the cognitive and behavioral model developed by Jean Piaget. Based on these developmental stages, pain assessment measures have been developed. Pharmacologic advances have accompanied this improved understanding of infant, child, and adolescent psychology. While acute pain accounts for the majority of children's experiences, recurrent/chronic pain states do occur (e.g. sickle cell related and neuropathic) and can be effectively treated. PMID:9037997

  7. Central modulation of pain

    PubMed Central

    Ossipov, Michael H.; Dussor, Gregory O.; Porreca, Frank

    2010-01-01

    It has long been appreciated that the experience of pain is highly variable between individuals. Pain results from activation of sensory receptors specialized to detect actual or impending tissue damage (i.e., nociceptors). However, a direct correlation between activation of nociceptors and the sensory experience of pain is not always apparent. Even in cases in which the severity of injury appears similar, individual pain experiences may vary dramatically. Emotional state, degree of anxiety, attention and distraction, past experiences, memories, and many other factors can either enhance or diminish the pain experience. Here, we review evidence for “top-down” modulatory circuits that profoundly change the sensory experience of pain. PMID:21041960

  8. Pain as a channelopathy

    PubMed Central

    Raouf, Ramin; Quick, Kathryn; Wood, John N.

    2010-01-01

    Mendelian heritable pain disorders have provided insights into human pain mechanisms and suggested new analgesic drug targets. Interestingly, many of the heritable monogenic pain disorders have been mapped to mutations in genes encoding ion channels. Studies in transgenic mice have also implicated many ion channels in damage sensing and pain modulation. It seems likely that aberrant peripheral or central ion channel activity underlies or initiates many pathological pain conditions. Understanding the mechanistic basis of ion channel malfunction in terms of trafficking, localization, biophysics, and consequences for neurotransmission is a potential route to new pain therapies. PMID:21041956

  9. Motor programs for abdominal positioning in crayfish

    Microsoft Academic Search

    James L. Larimer; Alan C. Eggleston

    1971-01-01

    Using chronically implanted suction electrodes (Fig. 2), records were obtained from the tonic abdominal flexor motor neurons of crayfish while they were undergoing various self-generated movements (Fig. 3). The main behavior examined in this study was one of abdominal extension (Fig. 1), a response which could be evoked repeatedly. Other stereotyped movements were also observed. Each class of behavior we

  10. Rare cause of abdominal incidentaloma: Hepatoduodenal ligament teratoma

    PubMed Central

    Jeismann, Vagner Birk; Dumarco, Rodrigo Blanco; Loreto, Celso di; Barbuti, Ricardo Correa; Jukemura, José

    2014-01-01

    The occurrence of a hepatoduodenal ligament teratoma is extremely rare, with only a few cases reported in the literature. This case report describes the discovery of a hepatoduodenal ligament lesion revealed during abdominal ultrasonography for cholelithiasis-related abdominal pain in a 27-year-old female. Cross-sectional imaging identified a 5 cm × 4 cm heterogeneous mass of fat tissue with irregular calcification located in the posterior-superior aspect of the head of the pancreas. An encapsulated lesion showing no invasion to the common bile duct or adjacent organs and vessels was exposed during laparotomy and resected. Intraoperative cholangiography during the cholecystectomy showed no abnormalities. The postoperative course was uneventful. Pathological analysis of the resected mass indicated hepatoduodenal ligament teratoma. This case report demonstrates that cross-sectional imaging, such as computed tomography, can reveal suspected incidences of this rare type of teratoma, which can then be confirmed after pathologic analysis of the specimen. The prognosis after complete surgical resection of lesions presenting with benign pathological features is excellent. PMID:24868330

  11. 21 CFR 884.5225 - Abdominal decompression chamber.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...2011-04-01 false Abdominal decompression chamber. 884.5225 Section...Devices § 884.5225 Abdominal decompression chamber. (a) Identification. An abdominal decompression chamber is a hoodlike device...

  12. 21 CFR 884.5225 - Abdominal decompression chamber.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...2012-04-01 false Abdominal decompression chamber. 884.5225 Section...Devices § 884.5225 Abdominal decompression chamber. (a) Identification. An abdominal decompression chamber is a hoodlike device...

  13. 21 CFR 884.5225 - Abdominal decompression chamber.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...2014-04-01 false Abdominal decompression chamber. 884.5225 Section...Devices § 884.5225 Abdominal decompression chamber. (a) Identification. An abdominal decompression chamber is a hoodlike device...

  14. 21 CFR 884.5225 - Abdominal decompression chamber.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...2010-04-01 false Abdominal decompression chamber. 884.5225 Section...Devices § 884.5225 Abdominal decompression chamber. (a) Identification. An abdominal decompression chamber is a hoodlike device...

  15. 21 CFR 884.5225 - Abdominal decompression chamber.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...2013-04-01 false Abdominal decompression chamber. 884.5225 Section...Devices § 884.5225 Abdominal decompression chamber. (a) Identification. An abdominal decompression chamber is a hoodlike device...

  16. Recognising and assessing blunt abdominal trauma.

    PubMed

    McGrath, Anthony; Whiting, Dean

    2015-03-01

    Blunt abdominal trauma is common following major traumatic injury but may not be recognised quickly enough and is therefore a cause of preventable death in trauma patients. Emergency department nurses have a major role to play in reducing the incidence of unrecognised abdominal trauma by enhancing their knowledge and skills. They can do this by attending trauma-related courses, taking on more expanded roles, carrying out full and comprehensive physical assessments, and ensuring that members of the multidisciplinary team use the wide range of diagnostic adjuncts available to them. This article reviews the anatomy and physiology of the abdominal cavity, explains abdominal trauma, gives an overview of advanced abdominal assessment techniques and diagnostic adjuncts, and reviews some management strategies for uncontrolled haemorrhage that have been adopted in the UK. PMID:25746888

  17. Abdominal tuberculosis of the gastrointestinal tract: Revisited

    PubMed Central

    Debi, Uma; Ravisankar, Vasudevan; Prasad, Kaushal Kishor; Sinha, Saroj Kant; Sharma, Arun Kumar

    2014-01-01

    Abdominal tuberculosis is an increasingly common disease that poses diagnostic challenge, as the nonspecific features of the disease which may lead to diagnostic delays and development of complications. This condition is regarded as a great mimicker of other abdominal pathology. A high index of suspicion is an important factor in early diagnosis. Abdominal involvement may occur in the gastrointestinal tract, peritoneum, lymphnodes or solid viscera. Various investigative methods have been used to aid in the diagnosis of abdominal tuberculosis. Early diagnosis and initiation of antituberculous therapy and surgical treatment are essential to prevent morbidity and mortality. Most of the patients respond very well to standard antitubercular therapy and surgery is required only in a minority of cases. Imaging plays an important role in diagnosis of abdominal tuberculosis because early recognition of this condition is important. We reviewed our experience with the findings on various imaging modalities for diagnosis of this potentially treatable disease. PMID:25356043

  18. Pathology Case Study: Abdominal Distention

    NSDL National Science Digital Library

    Rao, Uma N. M.

    This is a case study presented by the University of Pittsburgh Department of Pathology, which describes a 60-year-old woman who presented with a history of marked abdominal distention lasted for several months with associated progressive fatigue, progressive weight loss and fever. Visitors are given patient history along with gross and microscopic descriptions, including images, and are given the opportunity to diagnose the patient. A "Final Diagnosis" section provides a discussion of the findings as well as references. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in soft tissue pathology.

  19. Chronic Low Back Pain due to Retroperitoneal Cystic Lymphangioma

    PubMed Central

    Fattahi, Asieh Sadat; Maddah, Godratollah; Motamedolshariati, Mohammad; Ghiasi–Moghadam, Taghi

    2014-01-01

    Abdominal cystic lymphangioma is a rare benign neoplasm. Less than 1% of lymphangiomas is in the retroperitoneum. Lymphangioma is mostly asymptomatic. Chronic symptoms were reported in retroperitoneal type more than others. Acute symptoms due to complications like infection, cyst rupture or hemorrhage may occur. We report an 18-years-old girl with low back pain from 6 months ago with huge pelvic mass and diagnosis of retroperitoneal cystic lymphangioma. PMID:25207319

  20. What a Pain! Kids and Growing Pains

    MedlinePLUS

    ... your leg looks red or is swollen (puffed up), your parent should take you to the doctor. Growing pains should not keep you from running, playing, ... reviewed: July 2012 For Teens For Kids For Parents MORE ON THIS TOPIC How Do Pain Relievers Work? I'm Growing Up - But Am I Normal? What Medicines Are and ...

  1. Chronic Pelvic Pain

    MedlinePLUS

    ... with pain. Such types include relaxation exercises and biofeedback . FREQUENTLY ASKED QUESTIONS FAQ099 GYNECOLOGIC PROBLEMS The American ... pain signals from reaching tissues and organs. Glossary Biofeedback: A technique in which an attempt is made ...

  2. Communicating about Cancer Pain

    Cancer.gov

    Patients with cancer may be reluctant to discuss their pain with their doctors for a variety of reasons. NCI sponsors research that examines the barriers that prevent patients from talking about pain.

  3. Pain: Hope through Research

    MedlinePLUS

    ... comes with its own telltale brand of pain. Migraines are characterized by throbbing head pain, sensitivity to ... and visual disturbances that begine before the headache. Migraines are more frequent in women than men. Stress ...

  4. What's wrong with pain?

    E-print Network

    Shriver, Adam Joseph

    2006-10-30

    are quickly confronted with difficult questions. This thesis, through an examination of a particular feature of moral language and a description of recent research on pain, provides an analysis of how pain fits into ethical theory. It is argued...

  5. Dysmenorrhea: Painful Periods

    MedlinePLUS

    ... dysmenorrhea? Glossary What is dysmenorrhea? Pain associated with menstruation is called dysmenorrhea . How common is dysmenorrhea? Dysmenorrhea ... the menstrual period? Pain usually occurs right before menstruation starts, as the level of prostaglandins increases in ...

  6. Neuropathic pain in leprosy.

    PubMed

    Haanpää, Maija; Lockwood, Diana N J; Hietaharju, Aki

    2004-03-01

    Chronic neuropathic pain in treated leprosy has received scant attention. In this article the concept, clinical features and diagnosis of neuropathic pain are reviewed. The possible pathophysiological mechanisms, treatment challenges and research needs in this area are discussed. PMID:15072122

  7. Alternative medicine - pain relief

    MedlinePLUS

    ... relieve pain due to: Cancer Carpal tunnel syndrome Fibromyalgia Childbirth (labor) Musculoskeletal injuries (such as the neck, ... pain for: After surgery or labor Arthritis Cancer Fibromyalgia Irritable bowel syndrome Migraine headache Tension headache Both ...

  8. Patient Education on Pain

    MedlinePLUS

    ... Education Annual Meeting Safe Prescribing Resources Clinical Pearls Patient Center Home > Patient Center > Patient Education > Patient Education ... to People with Pain Press Room Position Statements Patient Education on Pain AAPM Past President, Perry G. ...

  9. What Is Back Pain?

    MedlinePLUS

    ... herniated disks National statistics on back pain costs Socioeconomic factors that relate to back pain costs and treatment. ... Skin Diseases (NIAMS) Information Clearinghouse National Institutes of Health 1 AMS Circle Bethesda, MD 20892-3675 Phone: ...

  10. Pain in Parkinson's Disease

    MedlinePLUS

    ... for increased overall health care costs. A person’s perception of pain can be affected by emotional factors. ... medications such as levodopa can affect a person’s perception of pain. People with Parkinson’s who are in ...

  11. Pain and your emotions

    MedlinePLUS

    ... low back pain: physical training, graded activity with problem solving training, or both? The one-year post-treatment results of a randomized controlled trial. Pain . 2008;134:263-276. Kroenke K, Bair ...

  12. Magnets for Pain Relief

    MedlinePLUS

    ... for any health-related purpose, yet static, or permanent, magnets are widely marketed for pain control. This fact ... Blackman MR, Kingman A, et al. Low intensity permanent magnets in the treatment of chronic lumbar radicular pain. ...

  13. Fighting Chronic Pain

    MedlinePLUS

    ... and inflammation Heart/Blood Vessels: Heart attack, angina, leg pain from clogged arteries Stomach/Digestive: Gallstones, intestinal obstruction, diverticulitis, ulcers, severe indigestion, severe gas pain, inflammatory bowel disease, ...

  14. Multidimensional pain evaluation scale.

    PubMed

    Sousa, Fátima Aparecida Emm Faleiros; Pereira, Lilian Varanda; Cardoso, Roberta; Hortense, Priscilla

    2010-01-01

    This study developed a pain evaluation scale and validated it for the Portuguese language. Development of the inventory--308 readily available pain descriptors--were searched in international literature and validated by six judges. One hundred descriptors of acute pain and 100 descriptors of chronic pain were found, which were used in the next stage. Statistical validation--493 health professionals and 146 patients experiencing acute and chronic pain participated in the study. Instructions, pain descriptors and respective definitions, pen and measuring tape were provided to participants. Psychophysical methods were used to establish categories, magnitude and cross-modality matching using line-length. Results revealed the ranking of the most frequently used descriptors of acute and chronic pain, with power equal to 0.99, close to the predicted (one), using line-length estimations. The Multidimensional Pain Evaluation Scale is thus validated for the Portuguese language. PMID:20428690

  15. Eldercare at Home: Pain

    MedlinePLUS

    ... listening to music may also decrease a person's awareness of pain. Avoid stressful events when possible. Emotional stress and anxiety increase pain. Try to minimize these types of situations. Carrying Out and Adjusting Your Plan : Problems You ...

  16. Exercise and Shoulder Pain

    MedlinePLUS

    ... the painful limb and should seek immediate medical attention. They should select other forms of exercise to ... cautions people to avoid exercise/activities that cause increased pain lasting an hour or more after exercise. ...

  17. An unusual case of abdominal distension: pneumoperitoneum secondary to pneumomediastinum in a patient with chronic obstructive pulmonary disease.

    PubMed

    Sturgeon, Jonathan P; Collard, Benjamin R B; Patel, Arjun K K; Devoto, Laurence

    2012-01-01

    A 68-year-old lady with end-stage chronic obstructive pulmonary disease presented with vomiting and abdominal pain. On examination her abdomen was grossly distended, diffusely tender and hyper-resonant. Imaging showed dilated loops of bowel and free air in the abdomen with no intestinal perforation. The free abdominal air had come down from the thorax by dissecting down around the oesophagus. A pneumomediastinum was present in her chest, secondary to her extensive emphysematous disease. She was treated conservatively and her pneumomediastinum resolved several weeks later, with subsequent resumption of intestinal motility and return to premorbid function. Surgical intervention would not have helped her condition. PMID:23060378

  18. Analgesic efficacy of a combination of hydrocodone with ibuprofen in postoperative pain

    Microsoft Academic Search

    Gilder L. Wideman; Marie Keffer; Elena Morris; Ralph T. Doyle; John G. Jiang; William T. Beaver

    1999-01-01

    Two randomized, double-blind, parallel-group single-dose 2 × 2 factorial analgesic studies compared a single-dose or a 2-tablet dose of a combination of 7.5 mg hydrocodone bitartrate with 200 mg ibuprofen with each constituent alone and with a placebo in women with moderate or severe postoperative pain from abdominal or gynecologic surgery. A nurse-observer recorded patient reports of pain intensity and

  19. Posttonsillectomy pain in children.

    PubMed

    Sutters, Kimberly A; Isaacson, Glenn

    2014-02-01

    Tonsillectomy, used to treat a variety of pediatric disorders, including obstructive sleep apnea, peritonsillar cellulitis or abscesses, and very frequent throat infection, is known to produce nausea, vomiting, and prolonged, moderate-to-severe pain. The authors review the causes of posttonsillectomy pain, current findings on the efficacy of various pharmacologic and nonpharmacologic interventions in pain management, recommendations for patient and family teaching regarding pain management, and best practices for improving medication adherence. PMID:24445532

  20. Neuropathic low back pain

    Microsoft Academic Search

    Joseph F. Audette; Emmanuel Emenike; Alec L. Meleger

    2005-01-01

    In this discussion, we hope to advance a clinical approach to low back pain that is more in line with our modern understanding\\u000a of neuropathic pain. We review the current understanding of normal and pathologic neuroanatomy of the lumbar spine and then\\u000a outline how pathology in the different structures can lead to neuropathic pain and cause common pain patterns seen

  1. Chronic pain and cost: an epidemiological study in the communities of Sunsari district of Nepal.

    PubMed

    Bhattarai, Balkrishna; Pokhrel, Paras Kumar; Tripathi, Mukesh; Rahman, Tashneem Roshan; Baral, Dharani Dhar; Pande, Rajesh; Bhattachaya, Abhjit

    2007-03-01

    The purpose of the study was to find out the prevalence of chronic pain in economically active population and associated economic loss. This cross-sectional observational study was carried out in 3 VDCs of Sunsari District involving 1730 individuals of 15-64 years age group selected by multistage random sampling. Demographic data, absence or presence of pain, site, severity, duration and relieving measures, approximate expenditure in treating pain and number of days lost due to pain were noted using a preformed questionnaire. Out of 1730 individuals interviewed, 882 (50.1%) had pain of which 93.7% had chronic pain (pain lasting for > 3 months). Backache (25.8%), headache (20.1%) and abdominal pain due to acid peptic disease (12.5%) were the most prevalent painful conditions. About 14.0% of individuals had severe grade pain. Female sex, age e"30 years, lack of formal schooling, smoking habit and dependent status were associated with higher prevalence of pain. Almost 19.0% of individuals with pain were unable to go to work the previous day. Man-days loss due to pain was 1.37 days/month/person in the study population. In terms of cost, pain related losses were Nepalese Rupees (NRs) 1671.89/person/year as against the per capita GDP of NRs 98,640.00 (US$ 1370.0). The money incurred by individuals for therapy on pain was NRs 760.15/person/year. In conclusion, probably first time, we are reporting the prevalence of chronic pain in our communities with people having to spend significant portion of their scarce income (and country's GDP) to treat pain, thus, highlighting it as a public health problem. PMID:17593670

  2. Pediatric Procedural Pain

    ERIC Educational Resources Information Center

    Blount, Ronald L.; Piira, Tiina; Cohen, Lindsey L.; Cheng, Patricia S.

    2006-01-01

    This article reviews the various settings in which infants, children, and adolescents experience pain during acute medical procedures and issues related to referral of children to pain management teams. In addition, self-report, reports by others, physiological monitoring, and direct observation methods of assessment of pain and related constructs…

  3. Approaching cancer pain relief

    Microsoft Academic Search

    J. Norelle Lickiss

    2001-01-01

    Pain is defined as an unpleasant experience—it is subjective and achieving pain relief is achieving a change in the patient's experience. There needs to be an adequate concept of a human person (an ecological model will be discussed) and a logical process for approaching pain relief in an individual patient (e.g. the plan used in the Sydney Institute of Palliative

  4. Cannabinoids in cancer pain

    Microsoft Academic Search

    Franjo Grotenhermen

    2010-01-01

    This article of the month presents results of a clinical study conducted in the UK and Romania, which evaluated the efficacy of a THC:CBD cannabis extract (Sativex®) and a THC cannabis ex- tract in the treatment of 177 patients with cancer pain, who experienced inadequate pain reduction despite intake of opioids (Johnson et al. J Pain Symptom Manage, 2010, in

  5. Complex Regional Pain Syndrome

    MedlinePLUS

    Complex regional pain syndrome (CRPS) is a chronic pain condition. It causes intense pain, usually in the arms, hands, legs, or feet. It may happen ... move the affected body part The cause of CRPS is unknown. There is no specific diagnostic test. ...

  6. [Neurosurgical treatments for pain].

    PubMed

    Pirotte, B

    2012-09-01

    Pain represents the most frequent symptom faced by general practitioners and is associated with 60% of neurological troubles. Pain consists in a conscious, subjective, unpleasant and protective sensory experience transmitted by thermoalgic pathways in the central nervous system (nociceptive pain). Lesioning of peripheral or central sensory pathways can also generate pain associated with hypoesthesia (phantom or neuropathic pain). Since the 1920's, neurosurgeons have attempted to alleviate nociceptive and neuropathic chronic pain by interrupting (irreversible interruptive techniques) thermoalgic fibers (neurotomies, rhizotomies, cordotomies, tractotomies, thalamotomies, cingulotomies). Some of them (neurotomies, rhizotomies) are still used today when all medications have failed. They can provide immediate and tremendous pain relief like in trigeminal neuralgia. However, the technique, when not sufficiently selective, can generate a neuropathic pain and then a short-lating pain relief. Increasing knowledge on pathophysiological mechanisms of pain allowed surgery to interfere with the functioning of the sensory circuits without lesioning and to modulate neuronal activity in order to reduce pain (neuromodulation). Non-lesioning modulating techniques (then reversible) appeared (deep brain stimulation, epidural spinal cord or motor cortex stimulation, intrathecal infusion, radiosurgery) and are currently applied to efficiently alleviate neuropathic pain. PMID:23091942

  7. Traumatic abdominal hernia complicated by necrotizing fasciitis.

    PubMed

    Martínez-Pérez, Aleix; Garrigós-Ortega, Gonzalo; Gómez-Abril, Segundo Ángel; Martí-Martínez, Eva; Torres-Sánchez, Teresa

    2014-11-01

    Necrotizing fasciitis is a critical illness involving skin and soft tissues, which may develop after blunt abdominal trauma causing abdominal wall hernia and representing a great challenge for physicians. A 52-year-old man was brought to the emergency department after a road accident, presenting blunt abdominal trauma with a large non-reducible mass in the lower-right abdomen. A first, CT showed abdominal hernia without signs of complication. Three hours after ICU admission, he developed hemodynamic instability. Therefore, a new CT scan was requested, showing signs of hernia complication. He was moved to the operating room where a complete transversal section of an ileal loop was identified. Five hours after surgery, he presented a new episode of hemodynamic instability with signs of skin and soft tissue infection. Due to the high clinical suspicion of necrotizing fasciitis development, wide debridement was performed. Following traumatic abdominal wall hernia (TAWH), patients can present unsuspected injuries in abdominal organs. Helical CT can be falsely negative in the early moments, leading to misdiagnosis. Necrotizing fasciitis is a potentially fatal infection and, consequently, resuscitation measures, wide-spectrum antibiotics, and early surgical debridement are required. This type of fasciitis can develop after blunt abdominal trauma following wall hernia without skin disruption. PMID:25541927

  8. Management of intra-abdominal hypertension and abdominal compartment syndrome: a review

    PubMed Central

    2014-01-01

    Patients in the intensive care unit (ICU) are at risk of developing of intra abdominal hypertension (IAH) and abdominal compartment syndrome (ACS). Aim: This review seeks to define IAH and ACS, identify the aetiology and presentation of IAH and ACS, identify IAP measurement techniques, identify current management and discuss the implications of IAH and ACS for nursing practice. A search of the electronic databases was supervised by a health librarian. The electronic data bases Cumulative Index of Nursing and Allied Health Literature (CINAHL); Medline, EMBASE, and the World Wide Web was undertaken from 1996- January 2011 using MeSH and key words which included but not limited to: abdominal compartment syndrome, intra -abdominal hypertension, intra-abdominal pressure in adult populations met the search criteria and were reviewed by three authors using a critical appraisal tool. Data derived from the retrieved material are discussed under the following themes: (1) etiology of intra-abdominal hypertension; (2) strategies for measuring intra-abdominal pressure (3) the manifestation of abdominal compartment syndrome; and (4) the importance of nursing assessment, observation and interventions. Intra-abdominal pressure (IAP) and abdominal compartment syndrome (ACS) have the potential to alter organ perfusion and compromise organ function. PMID:24499574

  9. Urolithiasis presenting as right flank pain: a case report

    PubMed Central

    Chung, Chadwick; Stern, Paula J.; Dufton, John

    2013-01-01

    Background: Urolithiasis refers to renal or ureteral calculi referred to in lay terminology as a kidney stone. Utolithiasis is a potential emergency often resulting in acute abdominal, low back, flank or groin pain. Chiropractors may encounter patients when they are in acute pain or after they have recovered from the acute phase and should be knowledgeable about the signs, symptoms, potential complications and appropriate recommendations for management. Case presentation: A 52 year old male with acute right flank pain presented to the emergency department. A ureteric calculus with associated hydronephrosis was identified and he was prescribed pain medications and discharged to pass the stone naturally. One day later, he returned to the emergency department with severe pain and was referred to urology. He was managed with a temporary ureteric stent and antibiotics. Conclusion: This case describes a patient with acute right flank and lower quadrant pain which was diagnosed as an obstructing ureteric calculus. Acute management and preventive strategies in patients with visceral pathology such as renal calculi must be considered in patients with severe back and flank pain as it can progress to hydronephrosis and kidney failure. PMID:23483000

  10. The influence of children's pain memories on subsequent pain experience.

    PubMed

    Noel, Melanie; Chambers, Christine T; McGrath, Patrick J; Klein, Raymond M; Stewart, Sherry H

    2012-08-01

    Healthy children are often required to repeatedly undergo painful medical procedures (eg, immunizations). Although memory is often implicated in children's reactions to future pain, there is a dearth of research directly examining the relationship between the 2. The current study investigated the influence of children's memories for a novel pain stimulus on their subsequent pain experience. One hundred ten healthy children (60 boys) between the ages of 8 and 12 years completed a laboratory pain task and provided pain ratings. Two weeks later, children provided pain ratings based on their memories as well as their expectancies about future pain. One month following the initial laboratory visit, children again completed the pain task and provided pain ratings. Results showed that children's memory of pain intensity was a better predictor of subsequent pain reporting than their actual initial reporting of pain intensity, and mediated the relationship between initial and subsequent pain reporting. Children who had negatively estimated pain memories developed expectations of greater pain prior to a subsequent pain experience and showed greater increases in pain ratings over time than children who had accurate or positively estimated pain memories. These findings highlight the influence of pain memories on healthy children's expectations of future pain and subsequent pain experiences and extend predictive models of subsequent pain reporting. PMID:22560288

  11. An Introduction Significance of Pain

    E-print Network

    Meagher, Mary

    and chronic pain. Because animals cannot verbally report on their pain, this state must be inferred using become sensitized (hyperalgesic) for the duration of an injury #12;Pathological Pain - Chronic Pain Inflammation or nerve damage !!65 -90 million in US !!Arthritis !!Neuropathic pain !!Back pain !!Migraine

  12. Ethnic differences in pain and pain management

    PubMed Central

    Campbell, Claudia M; Edwards, Robert R

    2012-01-01

    SUMMARY Considerable evidence demonstrates substantial ethnic disparities in the prevalence, treatment, progression and outcomes of pain-related conditions. Elucidating the mechanisms underlying these group differences is of crucial importance in reducing and eliminating disparities in the pain experience. Over recent years, accumulating evidence has identified a variety of processes, from neurophysiological factors to structural elements of the healthcare system, that may contribute to shaping individual differences in pain. For example, the experience of pain differentially activates stress-related physiological responses across various ethnic groups, members of different ethnic groups appear to use differing coping strategies in managing pain complaints, providers’ treatment decisions vary as a function of patient ethnicity and pharmacies in predominantly minority neighborhoods are far less likely to stock potent analgesics. These diverse factors, and others may all play a role in facilitating elevated levels of pain-related suffering among individuals from ethnic minority backgrounds. Here, we present a brief, nonexhaustive review of the recent literature and potential physiological and sociocultural mechanisms underlying these ethnic group disparities in pain outcomes. PMID:23687518

  13. Radical Distal Pancreatectomy with En Bloc Resection of the Celiac Artery, Plexus, and Ganglions for Advanced Cancer of the Pancreatic Body: A Preliminary Report on Perfect Pain Relief

    Microsoft Academic Search

    Satoshi Kondo; Hiroyuki Katoh; Makoto Omi; Satoshi Hirano; Yoshiyasu Ambo; Eiichi Tanaka; Shunichi Okushiba; Toshiaki Morikawa; Michio Kanai; Takashi Yano

    2001-01-01

    Objective The purpose of this study was to report the effect of radical distal pancreatectomy with en bloc resection of the celiac artery, plexus, and ganglions for locally advanced cancer of the pancreatic body on intractable abdominal and\\/or back pain and to explore the histopathologic mechanism of this pain. Patients Five patients with pancreatic body cancer involving the celiac and\\/or

  14. Greater trochanteric hip pain.

    PubMed

    Kimpel, Diane M; Garner, Chadwick C; Magone, Kevin M; May, Jedediah H; Lawless, Matthew W

    2014-01-01

    In the patient with lateral hip pain, there is a broad differential diagnosis, making appropriate evaluation and management challenging. Greater trochanteric pain syndrome is a term used to denote chronic lateral hip pain and encompasses several painful soft tissue diagnoses including coxa saltans, trochanteric bursitis, and gluteus minimus and medius tendon tears. An overview of these common causes is presented through a series of cases that encompass the anatomic associations, classic presentations, diagnostic tests, and management strategies unique to each disorder. By reviewing this information, we hope to provide clinicians with the tools to evaluate greater trochanteric pain syndrome efficiently and effectively. PMID:24651142

  15. Heel pain and phonophoresis.

    PubMed

    Deshpande, Milind M; Patil, C B

    2010-06-01

    A review of 25 cases of heel pain treated conservatively with phonophoresis, using the anti-inflammatory gel containing a combination of flufenamic acid, salicylic acid and mucopolysaccharide polysulphate is being reported here. The purpose of the study was to assess the effectiveness of a noninvasive procedure called phonophoresis in treating hell pain. It involved usage of ultrasound waves to deliver anti-inflammatory drugs to the painful site. The heel pain subsided in all the cases and did not recur for a period of one year till last reviewed indicating the definite role of phonophoresis in heel pain. PMID:21121387

  16. The effects of surface condition on abdominal muscle activity during single-legged hold exercise.

    PubMed

    Ha, Sung-min; Oh, Jae-seop; Jeon, In-cheol; Kwon, Oh-yun

    2015-02-01

    To treat low-back pain, various spinal stability exercises are commonly used to improve trunk muscle function and strength. Because human movement for normal daily activity occurs in multi-dimensions, the importance of exercise in multi-dimensions or on unstable surfaces has been emphasized. Recently, a motorized rotating platform (MRP) for facilitating multi-dimensions dynamic movement was introduced for clinical use. However, the abdominal muscle activity with this device has not been reported. The purpose of this study was to compare the abdominal muscle activity (rectus abdominis, external and internal oblique muscles) during an active single-leg-hold (SLH) exercise on a floor (stable surface), foam roll, and motorized rotating platform (MRP). Thirteen healthy male subjects participated in this study. Using electromyography, the abdominal muscle activity was measured while the subjects performed SLH exercises on floor (stable surface), foam roll, and MRP. There were significant differences in the abdominal muscle activities among conditions (P<.05), except for left EO (P>.05) (Fig. 2). After the Bonferroni correction, however, no significant differences among conditions remained, except for differences in both side IO muscle activity between the floor and foam roll conditions (padj<0.017). The findings suggest that performing the SLH exercises on a foam roll and MRP is more effective increased activities of both side of RA and IO, and Rt. EO compared to floor condition. However, there were no significant differences in abdominal muscles activity in the multiple comparison between conditions (mean difference were smaller than the standard deviation in the abdominal muscle activities) (padj>0.017), except for differences in both side IO muscle activity between the floor (stable surface) and foam roll (padj<0.017) (effect size: 0.79/0.62 (non-supporting/supporting leg) for foam-roll versus floor). PMID:25066516

  17. Unrelieved pain: A crisis

    PubMed Central

    Sessle, Barry J

    2011-01-01

    Despite many recent advances in the past 40 years in the understanding of pain mechanisms, and in pain diagnosis and management, considerable gaps in knowledge remain, with chronic pain present in epidemic proportions in most countries. It is often unrelieved and is associated with significant socioeconomic burdens. Several opportunities and approaches to address this crisis are identified in the present article. Most crucial is the need to increase pain awareness, enhance pain education, improve access to pain care and increase pain research resources. Given the variability among countries in health care policies and programs, resources and educational programs, many of the approaches and strategies outlined will need to be tailored to each country’s socioeconomic and educational situation. PMID:22184550

  18. [Pain in nursing homes].

    PubMed

    Nestler, N; Gnass, I; Schuler, M

    2015-02-01

    Elderly live in nursing homes if the necessary need for care cannot be realized in the home care setting. Dementia syndrome (60?% of nursing home residents) has a prominent role. Pain is a frequent problem in nursing homes, affecting functionality and quality of life. Studies often show inadequate pain therapy. Not only is the presentation of pain often atypical, but pharmacological and invasive pain therapy is limited by multimorbidity and increased risk of side effects. Nonpharmacological pain therapy is part of nursing therapy; however, the effect on nursing home residents has been insufficiently studied. This situation necessitates interprofessional coordination of all team members, in which the nursing pain assessment and the realization of both pharmacological and nonpharmacological pain therapy are very important. PMID:25701275

  19. Common medical pains

    PubMed Central

    Jacobson, Sheila

    2007-01-01

    Pain in infancy and childhood is extremely common. Sources of pain include illness, injury, and medical and dental procedures. Over the past two decades, tremendous progress has been made in the assessment, prevention and treatment of pain. It is important for the paediatric health care provider to be aware of the implications and consequences of pain in childhood. A multitude of interventions are available to reduce or alleviate pain in children of all ages, including neonates. These include behavioural and psychological methods, as well as a host of pharmacological preparations, which are safe and effective when used as indicated. Many complementary and alternative treatments appear to be promising in treating and relieving pain, although further research is required. The present article reviews the most common sources of pain in childhood and infancy, as well as current treatment strategies and options. PMID:19030348

  20. Pain syndromes in children.

    PubMed

    Sherry, D D

    2000-08-01

    The pediatric rheumatologist cares for children who may have a wide variety of causes of musculoskeletal pain. These include such diverse conditions as arthritis, low-back pain, hypermobility, metabolic bone pain, and amplified pain syndromes such as complex regional pain syndrome and fibromyalgia. This review examines the recent literature on these and other conditions causing musculoskeletal pain in children and adolescents. Overall, headway is being made, but differentiating soma from psyche remains a problem. This is perhaps due to the marked and unique effect pain brings to each of us. Children are different from adults in causes, presentations, and outcome. Vigilance in history, physical examination, and judicious use of laboratory investigations are usually sufficient in establishing a diagnosis, as well as an appreciation for the variety of presentations each condition can manifest. PMID:11123080

  1. The Tribolium homeotic gene Abdominal is homologous to abdominal-A of the Drosophila bithorax complex

    NASA Technical Reports Server (NTRS)

    Stuart, J. J.; Brown, S. J.; Beeman, R. W.; Denell, R. E.; Spooner, B. S. (Principal Investigator)

    1993-01-01

    The Abdominal gene is a member of the single homeotic complex of the beetle, Tribolium castaneum. An integrated developmental genetic and molecular analysis shows that Abdominal is homologous to the abdominal-A gene of the bithorax complex of Drosophila. abdominal-A mutant embryos display strong homeotic transformations of the anterior abdomen (parasegments 7-9) to PS6, whereas developmental commitments in the posterior abdomen depend primarily on Abdominal-B. In beetle embryos lacking Abdominal function, parasegments throughout the abdomen are transformed to PS6. This observation demonstrates the general functional significance of parasegmental expression among insects and shows that the control of determinative decisions in the posterior abdomen by homeotic selector genes has undergone considerable evolutionary modification.

  2. An equine pain face

    PubMed Central

    Gleerup, Karina B; Forkman, Björn; Lindegaard, Casper; Andersen, Pia H

    2015-01-01

    Objective The objective of this study was to investigate the existence of an equine pain face and to describe this in detail. Study design Semi-randomized, controlled, crossover trial. Animals Six adult horses. Methods Pain was induced with two noxious stimuli, a tourniquet on the antebrachium and topical application of capsaicin. All horses participated in two control trials and received both noxious stimuli twice, once with and once without an observer present. During all sessions their pain state was scored. The horses were filmed and the close-up video recordings of the faces were analysed for alterations in behaviour and facial expressions. Still images from the trials were evaluated for the presence of each of the specific pain face features identified from the video analysis. Results Both noxious challenges were effective in producing a pain response resulting in significantly increased pain scores. Alterations in facial expressions were observed in all horses during all noxious stimulations. The number of pain face features present on the still images from the noxious challenges were significantly higher than for the control trial (p = 0.0001). Facial expressions representative for control and pain trials were condensed into explanatory illustrations. During pain sessions with an observer present, the horses increased their contact-seeking behavior. Conclusions and clinical relevance An equine pain face comprising ‘low’ and/or ‘asymmetrical’ ears, an angled appearance of the eyes, a withdrawn and/or tense stare, mediolaterally dilated nostrils and tension of the lips, chin and certain facial muscles can be recognized in horses during induced acute pain. This description of an equine pain face may be useful for improving tools for pain recognition in horses with mild to moderate pain. PMID:25082060

  3. Endoluminal Abdominal Aortic Aneurysm Repair

    PubMed Central

    Ghouri, Maaz; Krajcer, Zvonimir

    2010-01-01

    Endovascular abdominal aortic aneurysm repair (EVAR) is an attractive alternative to open surgical repair. Distal endograft migration and type 1 endoleak are recognized to be the 2 main complications of EVAR. First-generation endografts had a stronger propensity for distal migration, modular component separation, thrombosis, and loss of structural integrity. Substantial progress has been made in recent years with 2nd- and 3rd-generation devices to prevent these complications. Some of the most common predictors of endograft failure are angulated and short infrarenal necks, large-diameter necks, and thrombus in the aneurysmal sac. The purpose of this study is to describe and review our experience in using innovative techniques and a newer generation of endografts to prevent distal migration and type 1 endoleak in patients with challenging infrarenal neck anatomy. The use of these innovative EVAR techniques and the new generation of endografts in patients with challenging infrarenal neck anatomy has yielded encouraging procedural and intermediate-term results. PMID:20200623

  4. Abdominal surgery. [Radiology, screening techniques

    SciTech Connect

    Welch, C.E.; Malt, R.A.

    1983-03-31

    A new art of ''interventional radiology'' has been developed in the past few years. Major applications include postoperative instrumentation of the biliary tract, percutaneous biliary drainage, tumor biopsy, abscess drainage, and intestinal-intubation procedures. Intervention by angiography encompasses injection of such substances as Pitressin (vasopressin), and embolization. These procedures have been of immense value. Fortunately, complications, such as sepsis and bleeding, have been infrequent. Computerized body tomography has also proved extremely important, particularly in the diagnosis of subphrenic abscess and pancreatic and pelvic pathology. /sup 99m/Tc-labeled-erythrocyte scans can be used to detect gastrointestinal bleeding sites. Scans can also identify hepatobiliary disease and splenic injury or differentiate the cause of jaundice. /sup 111/Indium-labeled autologous leukocytes may be useful in differentiating a pancreatic abscess from a pseudocyst. The advantage of indium scans over /sup 67/Ga scans is that a shorter time is required for maximum resolution: gallium requires 48 hours, indium 4. Another advantage is that indium is cleared through the liver and spleen and is not secreted into the bowel. /sup 67/Ga is absorbed by lymphomas and hepatocarcinomas. Nuclear magnetic resonance has many possible uses in abdominal surgery, but so far little information is available. This technique has been used to detect an empyema of the gallbladder that was not diagnosed by ultrasound. Among hepatic lesions, it can easily differentiate tumors from cysts and in that regard is superior to both ultrasound and scan. (JMT)

  5. Observations on intra-abdominal pressure and patterns of abdominal intra-muscular activity in man.

    PubMed

    Cresswell, A G; Grundström, H; Thorstensson, A

    1992-04-01

    The aim was to investigate possible relationships between activities of the individual muscles of the ventrolateral abdominal wall and the development of pressure within the abdominal cavity. Intra-muscular activity was recorded bilaterally from transversus abdominis, obliquus internus, obliquus externus and rectus abdominis with fine-wire electrodes guided into place using real-time ultrasound. Intra-abdominal pressure was measured intragastrically using a micro tip pressure transducer. Six males were studied during loading and movement tasks with varied levels of intra-abdominal pressure. During both maximal voluntary isometric trunk flexion and extension, transversus abdominis activity and intra-abdominal pressure remained constant, while all other abdominal muscles showed a marked reduction during extension. When maximal isometric trunk flexor or extensor torques were imposed upon a maximal Valsalva manoeuvre, transversus abdominis activity and intra-abdominal pressure remained comparable within and across conditions, whereas obliquus internus, obliquus externus and rectus abdominis activities either markedly increased (flexion) or decreased (extension). Trunk twisting movements showed reciprocal patterns of activity between the left and right sides of transversus abdominis, indicating an ability for torque development. During trunk flexion--extension, transversus abdominis showed less distinguished changes of activity possibly relating to a general stabilizing function. In varied pulsed Valsalva manoeuvres, changes in peak intra-abdominal pressure were correlated with mean amplitude electromyograms of all abdominal muscles, excluding rectus abdominis. It is concluded that the co-ordinative patterns shown between the muscles of the ventrolateral abdominal wall are task specific based upon demands of movement, torque and stabilization. It appears that transversus abdominis is the abdominal muscle whose activity is most consistently related to changes in intra-abdominal pressure. PMID:1534959

  6. [Current diagnostics for intra-abdominal trauma].

    PubMed

    Nast-Kolb, D; Bail, H J; Taeger, G

    2005-10-01

    In case of suspected intra-abdominal injury, fast transport of the patient to a suitable hospital is of high priority. The initial clinical examination aims at identifying patients with potentially life-threatening bleeding that require emergency surgery. In patients with penetrating trauma, laparoscopy is favoured to exclude suspected perforation of the peritoneum. If a peritoneal perforation is identified, exploratory laparotomy is recommended to exclude or treat lacerations of the hollow viscus. Although clinical examination should be performed its sensitivity and specificity of up to 82% and 45%, respectively, are not sufficient as the sole screening method. For the further diagnostic workup, diagnostic peritoneal lavage has been completely replaced by abdominal ultrasound examination in Germany and many other countries. Focussing not only on the detection of free abdominal fluid but also searching for parenchymal organ lesions and performing repeated examinations increases accuracy up to 96%, with specificity of 99.8% and sensitivity of 72.1%. Computed abdominal tomography with a helical scanner with and without intravenous contrast media is currently the gold standard of imaging techniques to identify traumatic abdominal injuries. A sensitivity of 97.2% and specificity of 94.7% can be achieved. False negative findings must be expected with hollow organ injuries. Serial clinical and ultrasound examinations as well as lab testing in conjunction with repeated CT may help to identify such lesions. Increased intra-abdominal pressure (IAP) with consecutive abdominal compartment syndrome and multiple organ dysfunction is a delayed complication from conditions such as severe intra-abdominal bleeding, major bleeding from pelvic ring fractures, and profuse fluid resuscitation. The IAP should be measured routinely in patients at risk, and decompression laparotomy may be indicated with pressures of higher than 20 mmHg. PMID:16170502

  7. A focus on intra-abdominal infections

    PubMed Central

    2010-01-01

    Complicated intra-abdominal infections are an important cause of morbidity and are frequently associated with poor prognosis, particularly in higher risk patients. Well defined evidence-based recommendations for intra-abdominal infections treatment are partially lacking because of the limited number of randomized-controlled trials. Factors consistently associated with poor outcomes in patients with intra-abdominal infections include increased illness severity, failed source control, inadequate empiric antimicrobial therapy and healthcare-acquired infection. Early prognostic evaluation of complicated intra-abdominal infections is important to select high-risk patients for more aggressive therapeutic procedures. The cornerstones in the management of complicated intra-abdominal infections are both source control and antibiotic therapy. The timing and the adequacy of source control are the most important issues in the management of intra-abdominal infections, because inadequate and late control of septic source may have a negative effect on the outcomes. Recent advances in interventional and more aggressive techniques could significantly decrease the morbidity and mortality of physiologically severe complicated intra-abdominal infections, even if these are still being debated and are yet not validated by limited prospective trials. Empiric antimicrobial therapy is nevertheless important in the overall management of intra-abdominal infections. Inappropriate antibiotic therapy may result in poor patient outcomes and in the appearance of bacterial resistance. Antimicrobial management is generally standardised and many regimens, either with monotherapy or combination therapy, have proven their efficacy. Routine coverage especially against Enterococci and candida spp is not always recommended, but can be useful in particular clinical conditions. A de escalation approach may be recommended in patients with specific risk factors for multidrug resistant infections such as immunodeficiency and prolonged antibacterial exposure. Therapy should focus on the obtainment of adequate source control and adequate use of antimicrobial therapy dictated by individual patient risk factors. Other critical issues remain debated and more controversies are still open mainly because of the limited number of randomized controlled trials. PMID:20302628

  8. Postoperative gastric dilatation causing abdominal compartment syndrome

    Microsoft Academic Search

    Ahmad Mahajna; Sharon Mitkal; Michael M Krausz

    2008-01-01

    OBJECTIVE: To study the effect of postoperative gastric dilatation on intra-abdominal pressure (IAP). DESIGN AND SETTING: Single case report from a primary teaching hospital. PATIENTS AND METHODS: A 72-year-old woman demonstrated a sudden respiratory and cardiovascular collapse following resection of a retroperitoneal sarcoma. This collapse was caused by abdominal compartment syndrome due to gastric dilatation. RESULTS: The patient was re-explored,

  9. Giant Subcutaneous Leiomyosarcoma of Anterior Abdominal Wall

    PubMed Central

    2014-01-01

    Subcutaneous leiomyosarcomas are rare tumors accounting for 1% to 2% of all superficial soft tissue malignancies. Although they may arise anywhere in the body, they most frequently occur in the lower extremities. The incidence of subcutaneous LMS affecting the anterior abdominal wall is very rare. We herein report the case of a patient with a giant subcutaneous leiomyosarcoma arising in the anterior abdominal wall. It was diagnosed by histopathology and immunohistochemistry and treated accordingly. PMID:25506027

  10. The pace of signs and symptoms of blunt abdominal trauma to children.

    PubMed

    Pariset, Jacquelyn M; Feldman, Kenneth W; Paris, Carolyn

    2010-01-01

    The authors describe the types, signs, and symptoms of blunt abdominal injury. Record reviews of children <5 years old were carried out at a regional children's hospital or level 1 trauma center between 1994 and 1999. Recognized cases of child abuse, penetrating trauma, or children with an unavailable chart were excluded. The mean age was 38 months (n = 42; range 11-59). Motor vehicle trauma caused most of the injuries (72%); 64% had isolated solid organ, 14% isolated hollow viscous, and 21% both organ injuries. Multisystem trauma included closed head injury (29%) and fractures (43%). Scene reports documented that 80% of those assessed immediately had abdominal pain. Average time taken to arrive at the emergency department was 66 minutes (range 15-420). Hollow viscous perforations were symptomatic from onset. The overall mortality rate was 12%, related to multitrauma. Most children suffering unintentional blunt abdominal trauma have immediate and ongoing injury. Caretakers promptly seek emergency care, and solid organ injuries predominate. The series mortality was low compared with that for abusive abdominal injuries. PMID:19628759

  11. A 7 years Old Girl with Abdominal Lump and Per-vaginal Bleeding of Hypothyroidism.

    PubMed

    Roy, N; Nahar, K; Begum, B; Sarker, U K; Akter, F; Roy, J; Chakrabarty, R

    2015-01-01

    Hypothyroidism is a common endocrine disorder resulting from decreased secretion of thyroid hormone. The diagnosis of hypothyroidism is suggested from the clinical and laboratory findings. Here we present a case report on this disease with rare presentation of abdominal lump and pervaginal bleeding in childhood. A 7 years old girl admitted in a tertiary level hospital with abdominal lump and irregular per vaginal bleeding. Abdominal swelling was gradually increasing in size & associated with lower abdominal pain for last 5 months. On examination the girl was moderately anaemic, mildly oedematous, distended lower abdomen and a mass in left iliac region. Her thyroid function test, serum FSH, serum LH, serum Prolactin was done and high FSH, LH, Prolactin levels were found. Ultrasonography of lower abdomen revealed bulky uterus and bilateral ovarian cysts. MRI of Brain showed feature of pituitary microadenoma. Finally the patient was diagnosed as primary hypothyroidism and bilateral follicular ovarian cyst with pituitary adenoma developed as its consequence. The case is reported for clinical awareness & to share our experience. PMID:25725684

  12. Chronic pain: lost inhibition?

    PubMed

    Henderson, Luke A; Peck, Chris C; Petersen, Esben T; Rae, Caroline D; Youssef, Andrew M; Reeves, Jenna M; Wilcox, Sophie L; Akhter, Rahena; Murray, Greg M; Gustin, Sylvia M

    2013-04-24

    Human brain imaging has revealed that acute pain results from activation of a network of brain regions, including the somatosensory, insular, prefrontal, and cingulate cortices. In contrast, many investigations report little or no alteration in brain activity associated with chronic pain, particularly neuropathic pain. It has been hypothesized that neuropathic pain results from misinterpretation of thalamocortical activity, and recent evidence has revealed altered thalamocortical rhythm in individuals with neuropathic pain. Indeed, it was suggested nearly four decades ago that neuropathic pain may be maintained by a discrete central generator, possibly within the thalamus. In this investigation, we used multiple brain imaging techniques to explore central changes in subjects with neuropathic pain of the trigeminal nerve resulting in most cases (20 of 23) from a surgical event. Individuals with chronic neuropathic pain displayed significant somatosensory thalamus volume loss (voxel-based morphometry) which was associated with decreased thalamic reticular nucleus and primary somatosensory cortex activity (quantitative arterial spin labeling). Furthermore, thalamic inhibitory neurotransmitter content was significantly reduced (magnetic resonance spectroscopy), which was significantly correlated to the degree of functional connectivity between the somatosensory thalamus and cortical regions including the primary and secondary somatosensory cortices, anterior insula, and cerebellar cortex. These data suggest that chronic neuropathic pain is associated with altered thalamic anatomy and activity, which may result in disturbed thalamocortical circuits. This disturbed thalamocortical activity may result in the constant perception of pain. PMID:23616562

  13. Multiple sclerosis and pain.

    PubMed

    Nick, Saeed Talebzadeh; Roberts, Charles; Billiodeaux, Seth; Davis, Debra Elliott; Zamanifekri, Behrouz; Sahraian, Mohammad Ali; Alekseeva, Nadejda; Munjampalli, Sai; Roberts, Joann; Minagar, Alireza

    2012-11-01

    Despite the common belief that multiple sclerosis (MS) is a painless disease, several studies contradict this. There are a significant number of MS patients who actually suffer from painful conditions such as central and peripheral neuropathy, migraines, trigeminal neuralgia, painful tonic spasms, complex regional pain syndrome, glossopharyngeal neuralgia, and transverse myelitis. In addition, MS relapses are usually painful with many patients complaining of paroxysmal dystonia and neuropathic pain during these episodes. Additionally, treatments for MS such as use of beta-interferons may be associated with headache and pain at the injection site. The pathophysiology of pain in MS is poorly understood, but may be related to the development of demyelinating lesions involving certain neuroanatomic pathways such as the spinothalamic tract. Management of pain in MS patients is a therapeutic challenge for clinicians. Currently, various pharmacological agents such as antiepielptics, non-steroidal anti-inflammatory agents, and even corticosteroids are used to suppress various painful conditions associated with MS. Non-pharmacological procedures such as massage therapy have also been used in the treatment of MS patients. The authors present a review of recent findings in pathophysiology and management of pain in MS patients. PMID:22909889

  14. Diagnosis of heel pain.

    PubMed

    Tu, Priscilla; Bytomski, Jeffrey R

    2011-10-15

    Heel pain is a common presenting symptom in ambulatory clinics. There are many causes, but a mechanical etiology is most common. Location of pain can be a guide to the proper diagnosis. The most common diagnosis is plantar fasciitis, a condition that leads to medial plantar heel pain, especially with the first weight-bearing steps in the morning and after long periods of rest. Other causes of plantar heel pain include calcaneal stress fracture (progressively worsening pain following an increase in activity level or change to a harder walking surface), nerve entrapment (pain accompanied by burning, tingling, or numbness), heel pad syndrome (deep, bruise-like pain in the middle of the heel), neuromas, and plantar warts. Achilles tendinopathy is a common condition that causes posterior heel pain. Other tendinopathies demonstrate pain localized to the insertion site of the affected tendon. Posterior heel pain can also be attributed to a Haglund deformity, a prominence of the calcaneus that may cause bursa inflammation between the calcaneus and Achilles tendon, or to Sever disease, a calcaneal apophysitis in children. Medial midfoot heel pain, particularly with continued weight bearing, may be due to tarsal tunnel syndrome, which is caused by compression of the posterior tibial nerve as it courses through the flexor retinaculum, medial calcaneus, posterior talus, and medial malleolus. Sinus tarsi syndrome occurs in the space between the calcaneus, talus, and talocalcaneonavicular and subtalar joints. The syndrome manifests as lateral midfoot heel pain. Differentiating among causes of heel pain can be accomplished through a patient history and physical examination, with appropriate imaging studies, if indicated. PMID:22010770

  15. Neurological diseases and pain

    PubMed Central

    2012-01-01

    Chronic pain is a frequent component of many neurological disorders, affecting 20–40% of patients for many primary neurological diseases. These diseases result from a wide range of pathophysiologies including traumatic injury to the central nervous system, neurodegeneration and neuroinflammation, and exploring the aetiology of pain in these disorders is an opportunity to achieve new insight into pain processing. Whether pain originates in the central or peripheral nervous system, it frequently becomes centralized through maladaptive responses within the central nervous system that can profoundly alter brain systems and thereby behaviour (e.g. depression). Chronic pain should thus be considered a brain disease in which alterations in neural networks affect multiple aspects of brain function, structure and chemistry. The study and treatment of this disease is greatly complicated by the lack of objective measures for either the symptoms or the underlying mechanisms of chronic pain. In pain associated with neurological disease, it is sometimes difficult to obtain even a subjective evaluation of pain, as is the case for patients in a vegetative state or end-stage Alzheimer's disease. It is critical that neurologists become more involved in chronic pain treatment and research (already significant in the fields of migraine and peripheral neuropathies). To achieve this goal, greater efforts are needed to enhance training for neurologists in pain treatment and promote greater interest in the field. This review describes examples of pain in different neurological diseases including primary neurological pain conditions, discusses the therapeutic potential of brain-targeted therapies and highlights the need for objective measures of pain. PMID:22067541

  16. Left lower quadrant pain of unusual cause 1 1 Clinical Communications (Adults) is coordinated by Ron M. Walls, MD, of Brigham and Women’s Hospital and Harvard University Medical School, Boston, Massachusetts

    Microsoft Academic Search

    Michael J. Nelson; Gene R. Pesola

    2001-01-01

    The differential diagnosis of left lower quadrant abdominal pain in an adult man includes, among others, sigmoid diverticulitis; leaking abdominal aortic aneurysm; renal colic; epididymitis; incarcerated hernia; bowel obstruction; regional enteritis; psoas abscess; and in this rare instance, situs inversus with acute appendicitis. We report a case of situs inversus totalis with left-sided appendicitis and a brief review of the

  17. Symptomatic schwannoma of the abdominal wall: A case report and review of the literature

    PubMed Central

    BALZAROTTI, RUBEN; RONDELLI, FABIO; BARIZZI, JESSICA; CARTOLARI, ROBERTO

    2015-01-01

    Schwannoma is a rare, benign tumor that arises from the nerve sheath. This tumor usually involves the extremities, but can also be found in the head and neck, trunk, pelvis, retroperitoneum, mediastinum and gastrointestinal tract. In numerous cases, the tumors are asymptomatic and are identified incidentally on physical examination or imaging. Occasionally, schwannoma is symptomatic due to compression of surrounding large nerves. In the present study, a 57-year-old female presented to the surgical outpatient’s department due to a well-localized parietal pain in the left lower quadrant. The onset of the pain occurred three years prior to presentation, without apparent cause and in the absence of other symptoms. Ultrasound and a computed tomography scan revealed a small solid tumor in the anterior abdominal wall, which was dimensionally stable over time, but was not noted in a preliminary analysis by a radiologist. The lesion was surgically removed using an anterior surgical approach. Histopathology revealed the tumor to be benign schwannoma. The painful symptoms completely disappeared. To the best of our knowledge, this is the third case of an abdominal wall benign schwannoma in the medical literature, and the first symptomatic case. PMID:25663862

  18. Genes and Abdominal Aortic Aneurysm

    PubMed Central

    Hinterseher, Irene; Tromp, Gerard; Kuivaniemi, Helena

    2010-01-01

    Abdominal aortic aneurysm (AAA) is a multifactorial disease with a strong genetic component. Since first candidate gene studies were published 20 years ago, nearly 100 genetic association studies using single nucleotide polymorphisms (SNPs) in biologically relevant genes have been reported on AAA. The studies investigated SNPs in genes of the extracellular matrix, the cardiovascular system, the immune system, and signaling pathways. Very few studies were large enough to draw firm conclusions and very few results could be replicated in another sample set. The more recent unbiased approaches are family-based DNA linkage studies and genome-wide genetic association studies, which have the potential of identifying the genetic basis for AAA, if appropriately powered and well-characterized large AAA cohorts are used. SNPs associated with AAA have already been identified in these large multicenter studies. One significant association was of a variant in a gene called CNTN3 which is located on chromosome 3p12.3. Two follow-up studies, however, could not replicate the association. Two other SNPs, which are located on chromosome 9p21 and 9q33 were replicated in other samples. The two genes with the strongest supporting evidence of contribution to the genetic risk for AAA are the CDKN2BAS gene, also known as ANRIL, which encodes an antisense RNA that regulates expression of the cyclin-dependent kinase inhibitors CDKN2A and CDKN2B, and DAB2IP, which encodes an inhibitor of cell growth and survival. Functional studies are now needed to establish the mechanisms by which these genes contribute to AAA pathogenesis. PMID:21146954

  19. A case report of ultrasound-guided interstitial brachytherapy for abdominal wall metastases of ovarian cancer

    PubMed Central

    Shi, Dan; Wu, Ning; Zhao, Hongfu; He, Mingyuan; Han, Dongmei

    2015-01-01

    Purpose To report the treatment effect of interstitial brachytherapy for abdominal wall metastases of ovarian cancer. Material and methods The patient is a 44-year-old female with a diagnosis of stage IA ovarian cancer. After surgery and two cycles of chemotherapy with paclitaxel and carboplatin, the patient noticed dull pain in the lower abdomen and found a mass located in the subcutaneous tissue, below the operative incision. A diagnostic biopsy showed abdominal wall metastases. After external radiotherapy with a dose of 39.6 Gy in 22 fractions, the residual tumor was treated with interstitial brachytherapy under ultrasound guidance. The brachytherapy dose was 18 Gy in 6 fractions of 3 Gy each. Results After 3 weeks of brachytherapy, the tumor had disappeared completely. Interstitial brachytherapy was feasible. Conclusions Interstitial brachytherapy may be a proposed treatment strategy for inoperable superficial metastases, especially for low radiosensitivity cancer.

  20. Abdominal wall endometrioma: a case report and review of the literature.

    PubMed

    Nissotakis, Christos; Zouros, Efstratios; Revelos, Kyriakos; Sakorafas, George H

    2010-06-01

    Endometriosis is the presence of ectopic endometrial tissue that can respond to ovarian hormonal stimulation. Although it is uncommon, extrapelvic endometriosis can form a discrete mass known as an abdominal wall endometrioma. Endometriomas are thought to be caused by transfer of endometrial cells into a surgical wound, most often after a cesarean delivery. Endometriomas are diagnosed via ultrasound, computed tomography, magnetic resonance imaging, and ultrasound-guided fine needle aspiration. Treatment options can be medical, but surgical excision is the treatment of choice. Perioperative nursing care includes patient teaching, taking steps to prevent surgical site infection and inadvertent hypothermia, ensuring availability of supplies (eg, the graft for abdominal wall repair if needed), and postoperative pain management. PMID:20510946