Showing papers on "Abdominal pain published in 1971"

Sigmoid volvulus. An examination of the mortality.

Abstract: The mortality of sigmoid volvulus was highest in patients who had the longest delays from onset to medical attention and from detection to management. Symptoms of abdominal pain and distention, particularly in an elderly or disturbed patient, should alert the physician to the diagnosis of sigmoid volvulus. Simple roentgenography of the abdomen and barium enema examination are valuable diagnostic adjuncts. Delay was most prominent in patients who resided in the hospital when volvulus occurred. Mortality was, as might be expected, higher in patients who had the most advanced medical disease. Aggressive pre- and postoperative care and precise medical management are imperative in such patients. Mortality was highest in patients who had inappropriate management. Unless signs of vascular compromise are present, sigmoidoscopic reduction should be attempted initially. If an exploratory laparotomy is necessary, exteriorization is preferable to resection or fixation of the sigmoid colon.

Ischaemic colitis and the contraceptive pill.

Abstract: A case report of a woman who suffered an attack of ischemic colitis while taking Ovulen is presented. The 39 year old woman had been taking Ovulen cyclically as a contraceptive for 2 years and had been changed to Ovulen 50 2 weeks before her admission to the hospital. The clinical course and radiological features in the patient were typical of ischemic colitis. She had a sudden left-sided abdominal pain followed by bloody diarrhea which rapidly improved without specific treatment. Barium-enema examination showed changes at the typical site which progressed from narrowing with marginal thumb-printing through sacculation to complete normality. The unusual feature was the patients age and sex. The condition usually occurs in the age group at risk from degenerative vascular disease more common in men. Previously there have been case reports of young oral contraceptive users who showed radiological evidence of transient ischemic colitis. It is recommended that ischemic colitis be considered in all young women who present with acute abdominal pain and blood-stained diarrhea who are taking a contraceptive pill.

Persistent abdominal pain

Abstract: Summary The organic and psychological problems of patients suffering from chronic abdominal pain are described and three case histories of patients who had undergone multiple surgery for their abdominal pain are presented. All three were treated by lumbar sympathetic lysis, resulting in relief of their pain. The possible reasons for this success are discussed.

Transit time related to clinical findings in children with recurrent abdominal pain

Abstract: Carmine was used as a marker to estimate the transit time through the gut of 306 children with recurrent abdominal pain (RAP) of whom 96 had migraine as well. They were compared with a further 160 children with migraine alone. Clinical examination revealed that having rectal constipation was present in 66 (22%) of children with RAP and transit was delayed in 91% of them. They presented distinctive features which suggest that rectal constipation alone may be a cause of RAP. In the remaining 240 children (78%) colonic spasm was thought to be responsible for attacks of abdominal pain. Transit time was prolonged in 44% and the colon was tender in 45% of cases. Colonic tenderness was associated more often with migraine and with a greater incidence and severity of intestinal delay than when colonic tenderness was absent. However in neither subgroup did the coexistence of migraine further delay intestinal transit. Children with migraine alone showed a delay in transit in 27% of cases, possibly accounted for mostly by colonic constipation, but delay is almost doubled in incidence and severity if abdominal pain supervenes with colonic tenderness. It is suggested that when rectal constipation has been excluded, children with RAP should be classified as cases of colonic spasm in view of the strong similarity with spastic colon of adults.

Septicemia with Pasteurella pseudotuberculosis and liver disease.

Abstract: There has been an increased awareness in recent years of Pasteurella pseudotuberculosis as a cause of human disease. Two basic forms of the infection have been noted, an often fatal septicemic form and a more benign acute mesenteric lymphadenitis. Most recent reports are concerned with the latter. 1,2 We had the opportunity of seeing two patients with the septicemic form, one of whom survived with treatment. Patient Summaries Patient 1. —A 64-year-old retired Marine Corps officer was admitted to the hospital April 1969 because of abdominal pain, fever, and chills for the previous month. Two weeks prior to admission he had noted the onset of diarrhea. He was treated with penicillin with no relief. Two days prior to admission he noted increasing abdominal girth and peripheral edema. He denied alcoholism, any exposure to toxins, or any drug ingestion. On admission the patient was icteric, his blood pressure was 150/80 mm

Abdominal lymphoma presenting with malabsorption.

Abstract: Twenty-three cases of abdominal lymphoma presenting with malabsorption seen at Groote Schuur Hospital over a 10-year period are reviewed. The clinical features, haematology, biochemistry, absorptive functions, radiologic and histological features are presented. Diarrhoea was a feature in all the cases while steatorrhoea occurred in 21. Intermittent abdominal pain, finger clubbing, and peripheral oedema were present in 50 per cent of the cases. Hepatosplenomegaly and abdominal masses were not frequent findings. Haematological investigations were similar to those found in any malabsorption syndrome. The erythrocyte sedimentation rate was above normal in 15 cases, but only above 30 mm/h in 10 cases. Routine tests of malabsorption were abnormal in most cases. Barium studies of the small bowel were abnormal in all 19 cases in which they were performed, and in six cases the diagnosis of lymphoma was suggested by the radiologist. Lymphangiography was of value in the four cases in which this procedure was carried out. The diagnostic value and drawbacks of peroral jejunal biopsy are stressed, lymphoma being present in biopsies of five patients and in five patients biopsies were completely normal. Thus in this series this suggests that peroral jejunal biopsies will be diagnostic in one-third, suggestive in one-third, and normal in one-third of patients with malabsorption due to lymphoma. Attention is drawn to the findings of total or partial villous atrophy, combined with 'plasma cell transformation' in the lamina propria. The results are compared to other series. Primary lymphoma and lymphoma secondary to idiopathic steatorrhoea is discussed and reasons are advanced to show that the cases in the present series were not secondary to idiopathic steatorrhoea. The possible pathogenesis and relationship to immunoglobulin deficiencies is discussed. The role of environmental factors is noted. The difficulties in making a diagnosis are mentioned and the importance of lymphoma as a cause of malabsorption in the Western Cape is stressed. The use of the term ‘Mediterranean type’ of abdominal lymphoma is regarded as a misnomer.

Recurrent abdominal pain due to milk and lactose intolerance in school-aged children.

Abstract: Five otherwise healthy children, ages 6 to 13 years, with episodes of abdominal pain, experienced the same symptoms with a lactose tolerance test and became asymptomatic on a diet low in milk products. None complained of diarrhea and all had been able to drink milk as infants. The abdominal pain was related to milk and lactose intolerance.

Symptomatic accessory lobe of the liver associated with absence of the left lobe.

Abstract: A 70-year-old woman had a large accessory liver lobe causing abdominal pain and requiring laparotomy. Four previous cases have been reported in the literature in which laparotomies were performed for acute abdominal symptoms secondary to torsion. In this case, there was no twist of the pedicle, and the symptoms were chronic. Atrophy of the left lobe was also present, perhaps related to the presence of postnecrotic cirrhosis. Excision of the accessory liver lobe was followed by complete disappearance of the symptoms.

Acute Appendicitis With Perforation

Abstract: We reviewed 100 cases of appendicitis with perforation during infancy and childhood, including symptoms, physical signs, delay in diagnosis, and preoperative preparation. The complications following appendicitis with perforation included wound abscess, pelvic abscess, intraperitoneal abscess, intestinal obstruction, fecal fistula, rectal bleeding, gram negative sepsis, and acute orchitis. A case report of a child with multiple complications is presented. Early diagnosis and operation, before perforation takes place, is the only means of prevention, and every physician caring for children should bear this admonition in mind, especially when examining the child with fever, abdominal pain, and vomiting.

Angioneurotic Edema of the Colon

Abstract: Angioneurotic edema of the colon produces a striking radiographic pattern of blister-like, rounded, edematous mucosal imprints in a localized segment on barium enema studies. The edema can form a mass, resulting in intussusception. Episodes of abdominal pain and cramping accompany the development of the colonic lesions.

Pasteurella pseudotuberculosis infection: three cases in the United States.

Abstract: Pasteurella pseudotuberculosis infection of the intestine produces a syndrome that simulates acute appendicitis. Prodromal malaise and anorexia, abdominal pain and tenderness localized in the right lower quadrant, fever, and leukocytosis are characteristics of the disease. In the typical patient, enlarged mesenteric lymph nodes are found at operation. The distal ileum may be thickened and edematous. Histologic sections show ulceration of the ileal mucosa and microabscesses within submucosal and lymph node germinal centers. Clinically, the disease may be distinguished from appendicitis by a test for agglutinating serum antibodies. Although a large number of cases in Europe have been reported, there have been no reports of Pasteurella pseudotuberculosis infection of human beings in the United States. Three such patients, all living in California, are reported with a description of the clinical and anatomic findings.

Zollinger-Ellison Syndrome in a Nineyear -old Child: A Case Report and Review of this Entity in Childhood

Abstract: In 1955, Zollinger and Ellison1 described a syndrome consisting of peptic ulceration, marked gastric hypersecretion, and non-beta islet cell tumor of the pancreas. Although there have been over 300 cases in the adult literature2-5 only 19 patients, 16 years old or younger have been reported. We add one more child to this growing list and review the clinical data of the known cases described. Case Report The patient (R.L.) was a 9-year-old Negro male with a 7-month history of intermittent episodes of mid-epigastric abdominal pain. The pain was somewhat relieved by eating, or the use of antispasmodics. During this period of time, the child had occasional episodes of vomiting, but no melena or hematemesis.

Gonococcal vulvovaginitis and possible peritonitis in prepubertal girls.

Abstract: There are few recent reports on gonococcal infections in young children, and peritonitis is rarely mentioned1-3We describe four prepubertal girls, one 10-year-old and three 6-year-olds, who presented with signs and symptoms compatible with peritonitis They represent approximately 10% (4:38) of the young girls seen at the Children's Mercy Hospital, Kansas City, Mo, from 1963 through 1970 with gonococcal vulvovaginitis Report of Cases Case1—This 10-year, 5-month-old Negro girl developed abdominal pain 24 hours before admission She was allegedly struck in the abdomen by a school mate prior to the onset of symptoms That evening the pain was so severe that she could not sleep Although the patient had nausea, there was no vomiting She had a bowel movement the day of admission She had never menstruated There was no history of sexual contact In the clinic her temperature was 1012 F (384 C), and she appeared slightly dehydrated

Giant diverticulum of the sigmoid colon.

Abstract: Giant diverticulum of the colon is a rare finding which has not so far been reported in the British radiological literature. A 66-year-old man was referred to hospital with a 24-hour history of abdominal pain and the passage of three melaena stools. Examination revealed some abdominal distension and tenderness, but no masses were felt. Bilateral inguinal herniae were noted for which a truss was worn. Sigmoidoscopy to a distance of 16 cm showed fresh melaena stool, but no mucosal lesion could be seen. First degree haemorrhoids were present, but these showed no sign of recent haemorrhage. A plain film of the abdomen revealed a large gas-filled “cyst” in the left lower quadrant (Fig. 1). The patient had a past history of a transthoracic vagotomy for obstructive airways disease, and repair of a ventral hernia. He had been under treatment with prednisone and various antibiotics for his chest condition. Barium enema examination revealed diverticular disease of the sigmoid colon. One of the diverticula measured ...

Case 9-1971

Abstract: Presentation of Case A two-year-old girl was admitted to the hospital because of abdominal pain. The child had been in good health until three days before admission, when she complained of abdomina...

Case 38-1971

Abstract: Presentation of Case A 66-year-old man entered the hospital because of abdominal pain and rectal bleeding. He had been well until nine years previously, when intermittent claudication developed. Tw...

Abdominal Pain in Acute Rheumatic Fever: An Unusual Demonstration of the Mimetic Nature of This Disease

Abstract: vessel grafts and plastic prosthesis for relief of superior vena caval obstruction. Surgery 30: 1008, 1955. 6. McIntire, F. T. and Sykes, E. M.: Obstruction of the superior vena cava: a review of the literature and report of two personal cases. Ann. Intern. Med. 84: 925, 1949. 7. Allansmith, R. and Richards, V.: Superior vena cava obstruction. Amer. J. Surg. 96: 351, 1958. 8. Klassen, K. P., Andrews, N. C. and Curtis, G. M.: Diagnosis and treatment of superior vena cava obstruction. AMA Arch. Surg. 68: 311, 1951. 9. Scannell, J. G. and Shaw, R. S.: Surgical reconstruction of the superior vena cava. J. Thorac. Surg. 28: 163, 1954. 10. Coley, B. L.: Neoplasms of Bone and Related Conditions, 2nd ed. New York, Paul B. Hoeber, Inc., 1960, p. 14. 11. Dahlin, D. C., Coventry, M. B. and Scanlon, P. W.: Ewing’s sarcoma. J. Bone Joint Surg. 43A: 185, 1961. 12. Falk, S. and Alpert, M.: The clinical and roentgen aspects of Ewing’s sarcoma. Amer. J. Med. Sci. 250: 492, 1965. 13. Falk, S. and Alpert, M.: Five year survival of patients with Ewing’s sarcoma. Surg. Gynec. Obstet. 124: 319, 1967. 14. Jenkin, R. D.: Ewing’s sarcoma: a study of treatment methods. Clin. Radiol. 17: 97, 1966. 15. McCormack, L. J., Dockerty, M. B. and Ghormley, R. K.: Ewing’s sarcoma. Cancer 5: 85, 1952. 16. Phillips, R. F. and Higinbotham, N. L.: The curability of Ewing’s endothelioma of bone in children. J. Pediat. 70: 391, 1967. 17. Graham, W.: Bone Tumors. London, Butterworths, 1965, p. 64. 18. Jaffe, H.: Tumor and Tumorous Conditions of the Bones and Joints. Philadelphia, Lea and Febiger, 1958, p. 241. 19. Lichtenstein, L.: Bone Tumors. New York, C. V. Mosby Co., 1969, p. 227.

Case 19-1971

Abstract: Presentation of Case A 69-year-old man was brought to the hospital because his family was unable to arouse him. Thirty-five years previously a duodenal ulcer had been demonstrated at laparotomy. Twelve years before admission he experienced an episode of prolonged anterior chest pain associated with the development of atrial flutter with 2:1 atrioventricular block. Physical examination disclosed a Grade 2 basal systolic murmur. The rhythm reverted to normal with the administration of digoxin. One year later he returned to the hospital because of persistent vomiting and abdominal pain and was found to have an active duodenal ulcer with obstruction; a . . .

Enterolith With Pseudogallstone Ileus

Abstract: To the Editor.— Gallstone ileus is a rare but well-defined entity that usually can be recognized easily at surgery. We report a case that closely resembled gallstone ileus but which was caused by a "pseudogallstone." Report of a Case.— A 55-year-old Tunisian farmer entered the hospital because of vomiting and abdominal pain. For several months he had noted vague diffuse abdominal pain. During the week before admission the pain became cramp-like and intense; there was bilious vomiting and obstipation. On examination the temperature was normal but he was hypotensive and oliguric. The abdomen was distended, tense, and tender throughout. The white blood cell count was 12,500/cu mm, red blood cell count was 3,900,000/ cu mm, and hemoglobin value was 42%. A plain film of the abdomen revealed an ovoid calculus in the pelvis. Small bowel distension was present. About three hours after admission the patient underwent laparotomy. Generalized peritonitis was

Small Vessel Arterial Aneurysms of the Kidney

Abstract: To the Editor.— Dornfield et al ( 215 : 1950, 1971) reached the conclusion that intrarenal artery aneurysms confined to the distal segmental, interlobar, and occasionally the arcuate arteries are specific for polyarteritis nodosa. A recent experience of discovering such aneurysms in a patient studied because of hematuria in whom open renal biopsy and subsequent examination of an extensive surgical specimen failed to demonstrate any evidence of polyarteritis prompts this report. Report of a Case.— A 49-year-old white mailman was admitted to the Springfield (Mass) Hospital Medical Center in January of 1971 because of abdominal pain and diarrhea. Eight years previously he had had an episode of painless gross hematuria which was investigated by means of intravenous pyelography and cystoscopy without any cause being found. The following year he had had the gradual onset of increasing diarrhea with weight loss. Initial x-ray film studies and endoscopy of the intestinal tract failed to

Two-and-one-half-year survival of patient with ruptured Wilms' tumor.

Abstract: To the Editor.— Rupture of a Wilms' tumor with intraperitoneal dissemination of tumor cel's rarely occurs. Of the few reported cases, all died either from the acute episode or soon afterwards from widespread metastases. 1,2 We recently observed such a case in which there was prolonged survival. Report of a Case.— A 5-year-old white boy was admitted to the Nassau County Medical Center because of severe abdominal pain. On the day prior to admission, after playing football with his father, he started to have continuous pain on the right side of his abdomen which became progressively worse. When examined he showed exquisite tenderness to abdominal palpation and percussion. There was boardlike rigidity, and obvious rebound tenderness. Bowel sounds were decreased and results of rectal examination were normal. The hemoglobin level was 10.4 gm/100 ml, hematocrit value was 33%, and white blood cell count was 17.700/cu mm, with 89% neutrophils, 5%

Duodenal Carcinoma Diagnosed by Hypotonic Duodenography and Small Bowel Enema

Abstract: Summary A case of adenocarcinoma of the third part of the duodenum is described. Presenting symptoms were abdominal pain and iron deficiency anaemia. Two barium meal series failed to adequately demonstrate the lesion, which was finally diagnosed by combined hypotonic duodenography and small bowel enema.

Amyloidosis as a manifestation of familial Mediterranean fever in siblings.

Abstract: This is the first report of familial mediterranean fever in two brothers (aged 12 and 10) from a middle class Muslim family in Iran, who were admitted to hospital with symptoms and signs of recurrent intermittent fever since childhood and with occasional abdominal pain and arthralgia. Exploratory laparotomy in one case revealed fibrinous peritonitis with swelling of the appendix and renal amyloidosis. In the other case needle biopsy revealed amyloidosis of the kidney.

Case 51-1971

Abstract: Presentation of Case First admission. A 51-year-old woman was admitted to the hospital because of abdominal pain. Forty years previously she had been told by a physician that she had a "small valve...