Showing papers on "Abdominal pain published in 1981"
TL;DR: The majority of cases have identifiable pathology within either the smooth muscle or myenteric plexus of the bowel wall, and pattern and distribution of the abnormalities are helpful in differentiating pseudo-obstruction from true mechanical obstruction.
177 citations
Journal Article•
TL;DR: Findings suggest that although single-vessel revascularization may relieve symptoms, the optimal long-term result can be obtained by complete revascularized of all stenotic vessels.
147 citations
TL;DR: The prognosis for abdominal aortic aneurysms could be considerably improved by increased awareness of its existence and early referral for treatment as an elective surgical procedure.
Abstract: Between 1960 and 1979 528 patients with abdominal aortic aneurysms presented to the university department of surgery. Of these, 222 (42%) were elective cases, 72 acute (14%), 174 had ruptured (33%), and four had had a spontaneous aortoduodenal fistula (1%). In all these patients resections were undertaken, but in another 56 patients (11%) the aneurysm was not resected. A review of these cases showed that 91% had symptoms at their first presentation; abdominal pain and backache being most common. The diagnosis could be established in 91% by the presence of pulsatile abdominal mass on clinical examination. The operative mortality for elective resection was 8%, for acute 19%, for ruptured cases 42%, and for spontaneous aortoduodenal fistula 50%. After successful resection the overall five-year survival was 65% by the life table method, and there was no significant difference between elective, acute, and ruptured cases. This five-year survival after resection compares favourably with the expected 76% survival of a similar normal population, and was considerably better than that for conservatively treated patients. As most cases have symptoms, and diagnosis may be established easily by routine physical examination in 91%, the prognosis for this condition could be considerably improved by increased awareness of its existence and early referral for treatment as an elective surgical procedure.
145 citations
TL;DR: The effectiveness of Bentyl (dicyclomine hydrochloride) 40 mg 4 times daily was evaluated in an ambulatory population with recent irritable bowel syndrome (IBS).
Abstract: The effectiveness of Bentyl (dicyclomine hydrochloride) 40 mg 4 times daily was evaluated in an ambulatory population with recent irritable bowel syndrome (IBS). During the 2-week double-blind study, the effects of dicyclomine hydrochloride compared to placebo were assesed by: 1) physicians' global evaluation of treatment, 2) patients' self-evaluation of treatment, and 3) patients' evaluation of duration of abdominal pain. It was concluded that over a 2-week period dicyclomine hydrochloride 40 mg 4 times a day is superior to placebo in improving the overall condition of the patient, decreasing abdominal pain, decreasing abdominal tenderness, and improving bowel habits. The majority of adverse effects reported were related to the anti-cholinergic activity of the drug.
129 citations
TL;DR: Seventy-four patients were operated on at Childrens Hospital of Los Angeles between 1951 and 1977 for abnormalities of intestinal rotation with or without volvulus, with a significant improvement from the 23% mortality previously reported.
Abstract: • Seventy-four patients were operated on at Childrens Hospital of Los Angeles between 1951 and 1977 for abnormalities of intestinal rotation with or without volvulus. The mortality in this group of patients was 4% and represents a significant improvement from the 23% mortality previously reported from this institution between 1937 and 1951. Neonatal patients had bilious vomiting and signs of high intestinal obstruction while older children had a more chronic course characterized by intermittent episodes of abdominal pain. Evaluation with contrast studies and early celiotomy is mandatory to prevent bowel necrosis. We outline the associated gastrointestinal anomalies and management of these combined anomalies. ( Arch Surg 116: 158-160, 1981)
103 citations
TL;DR: There was no correlation of the type of hematologic malignancy, occurrence or type of treatment, peripheral blood counts, or spleen size to survival, and the most important factor in predicting survival was appropriate surgery.
Abstract: Five cases of pathologic rupture of the spleen in patients with hematologic malignancy are presented along with a review of the 48 cases previously described in the English literature. Pathologic splenic rupture occurred most commonly in patients with acute leukemia but has been well documented in chronic leukemias and in lymphoma as well. Nearly all patients experience abdominal pain at the time of rupture; however, this pain was frequently confused clinically with that of biliary tract obstruction, aortic aneurysm, perforated viscus, pancreatitis, and angina pectoris. Pain referred to the left shoulder (Kehr's sign) was present in only 17% of patients. Hypotension was documented in 66%, fever in 74%, and tachycardia in 75%. The most effective diagnostic procedure was paracentesis, which confirmed intraabdominal hemorrhage in each of the nine cases in which the procedure was used. A correct preoperative diagnosis of splenic rupture was reported in only 10 of the 53 cases reviewed. Fifty-two percent of the patients underwent laparotomy; 48% died without operation. Of those that underwent surgery, 78% survived the procedure and the immediate postoperative period. The survival rate of all patients was 38%. There was no correlation of the type of hematologic malignancy, occurrence or type of treatment, peripheral blood counts, or spleen size to survival. The most important factor in predicting survival was appropriate surgery.
97 citations
TL;DR: It was demonstrated that the number of people experiencing threatening events fell to the expected level postoperatively and that depression was associated with continued abdominal pain, which may be relevant to the understanding of the irritable-bowel syndrome.
91 citations
TL;DR: In this paper, the authors presented 15 patients with ischemia of the colon and showed a similar clinical presentation with hematochezia, abdominal pain, and diarrhea in an elderly patient population having associated disease.
86 citations
TL;DR: A 28-year-old woman who complained of mild abdominal pain was found to have a large liver tumor that was felt to be unresectable because of its size, and no treatment was given other than withdrawal of oral contraceptives.
Abstract: A 28-year-old woman who complained of mild abdominal pain was found to have a large liver tumor. Angiography and needle biopsy established the diagnosis of hepatocellular adenoma. The tumor was felt to be unresectable because of its size, and no treatment was given other than withdrawal of oral contraceptives. Subsequent hepatic scintiscans documented complete resolution of the tumor over a 12-month period.
78 citations
Journal Article•
TL;DR: This work studied the case of a giant adrenal myelolipoma in a 70-year-old woman who was obese, hypertensive, and had abdominal pain, findings frequently associated with these lesions.
Abstract: Adrenal myelolipomas are rare tumors that consist of mature fat and bone-marrow elements. The majority that have been reported are small, asymptomatic lesions incidentally observed at the time of autopsy. In recent years, larger, symptomatic myelolipomas have been successfully resected. We studied the case of a giant adrenal myelolipoma in a 70-year-old woman. She was obese, hypertensive, and had abdominal pain, findings frequently associated with these lesions. Unusual features included formation of prominent bony spicules, a 52-year history of an abdominal mass, and massive size (5,500 g). To our knowledge, it is the largest myelolipoma yet reported.
67 citations
Journal Article•
TL;DR: The experience gives weight to the contention that, although jejunal and ileal diverticula are rare, in any collected experience with them, significant morbidity and mortality accompanies the complications.
Abstract: During a 25 year period at this medical center and the UCLA Center for Health Science, we identified 34 patients who had jejunal or ileal pseudodiverticula. Seventeen of these were treated for a more significant pathologic condition, the diverticula being an incidental finding. Of the remaining 17 patients, six underwent an operation for complications of these diverticula; two of them had diverticulitis of the jejunum; two, a perforated ileal diverticulum, and two others, severe malabsorption. Another two patients had laboratory evidence of malabsorption attributed to the presence of the diverticula and were treated medically. In the remaining nine persons, four were diagnosed as having a functional bowel syndrome and five had undiagnosed abdominal pain. For the group of six patients undergoing an operation, there was a 50 per cent mortality. Our experience gives weight to the contention that, although jejunal and ileal diverticula are rare, in any collected experience with them, significant morbidity and mortality accompanies the complications.
Journal Article•
TL;DR: Elastic vascular sclerosis (EVS) was identified in 19 of 22 cases with available histologic material and may contribute significantly to the evolution of ischemic changes in patients with midgut carcinoids.
TL;DR: Five diabetic patients developed upper back or abdominal pain associated with substantial weight loss in three and at least two have improved spontaneously, and the syndrome is closely related to diabetic amyotrophy.
Abstract: Five diabetic patients developed upper back or abdominal pain associated with substantial weight loss in three. Electrophysiological evidence of associated thoracoabdominal somatic neuropathy was found in all cases. Signs of a generalized neuropathy were present in two patients, and four had asymmetrical proximal leg weakness. At least two have improved spontaneously. The syndrome is closely related to diabetic amyotrophy; it is probably more common than is recognized.
Journal Article•
TL;DR: Those patients with hemorrhage associated with pseudocyst formation had the highest survival rates, whereas those with necrotizing pancreatitis and hemorrhage had an extremely poor response to aggressive medical and/or surgical management.
TL;DR: Hypercalcemia increases gastric acid secretion and may account for associated ulcer disease and the ulcer-like pain in primary hyperparathyroidism.
Abstract: To determine the frequency of gastrointestinal symptoms in primary hyperparathyroidism, we retrospectively analyzed 100 consecutive patients seen at Emory University Hospital from Jan 1, 1977 through March 1, 1979 At the time of diagnosis, 28 patients complained of nausea, 19 of vomiting, 29 of abdominal pain, and 33 of constipation One patient presented with acute pancreatitis and 14 had ulcer disease (two gastric and 12 duodenal ulcers) Hypercalcemia increases gastric acid secretion and may account for associated ulcer disease and the ulcer-like pain in primary hyperparathyroidism The mechanisms causing the other gastrointestinal symptoms in hypercalcemia remain to be elucidated These symptoms abate on correction of hyperparathyroidism
Journal Article•
TL;DR: A detailed analysis of 117 cases of enteric fever in Nigerian children shows that fever, abdominal pain, vomiting and diarrhoea were the main presenting features.
Abstract: A detailed analysis of 117 cases of enteric fever in Nigerian children shows that fever, abdominal pain, vomiting and diarrhoea were the main presenting features. Disorders of sensorium occurred in 50%. Associated conditions and bizarre manifestations often delayed the diagnosis and this, coupled with complications such as intestinal haemorrhage and perforation, adversely affected the mortality which was 32% in this study.
TL;DR: In this article, the patient described herein had well-documented, recurrent pancreatitis while he was taking valproic acid; however, pancreatitis must be considered whenever these symptoms are severe or protracted.
TL;DR: Sclerosing peritonitis developed in a 56-year-old white man who had been receiving propranolol for hypertension and angina pectoris since December 1976 and extensive adhesions were revealed which were so remarkable that the organs were fixed.
Journal Article•
TL;DR: It is concluded that nasogastric suction is not effective in the treatment of uncomplicated alcoholic pancreatitis.
TL;DR: Three nonsplenectomized patients were infected with Babesia microti and pentamidine appears to be useful in controlling clinical manifestations of babesiosis and decreasing parasitemia, but it does not eradicate the organism.
Abstract: Three nonsplenectomized patients were infected withBabesia microti. One had fever, abdominal pain suggesting gallbladder disease, and evidence of disseminated intravascular coagulation; an...
TL;DR: It is suggested that chest pain and upper abdominal pain in adolescents rarely arise from serious problems, but they can be effectively reassured and an expensive diagnostic and treatment program can be avoided.
TL;DR: The results of surgical treatment for chronic pancreatitis at a clinic and in the eight leading institutions of Japan were reviewed in a total of 328 cases as mentioned in this paper, where abdominal pain disappeared or was alleviated in about 90 percent of the patients who survived more than 6 months after operation.
Abstract: The results of surgical treatment for chronic pancreatitis at our clinic and in the eight leading institutions of Japan were reviewed in a total of 328 cases. Abdominal pain disappeared or was alleviated in about 90 percent of the patients who survived more than 6 months after operation. There was no significant differences in the effect of pain among the three main types of operations: pancreaticoduodenectomy, distal resection and pancreatic ductal drainage. In the collected cases, however, complete disappearance of pain was reported more often in patients subjected to Puestow's operation than in those who underwent Nardi's operation. The patients who underwent pancreatic ductal drainage had a greater postoperative weight gain than those without drainage, in both our patients and the collected cases. In the collected cases, Puestow's operation was predominantly linked to postoperative weight gain. Evidence of pancreatic functional improvement, either in endocrine or in exocrine, was very meager.
TL;DR: A 53-year-old woman with von Recklinghausen's disease since adolescence was admitted to the hospital for right-sided upperquadrant abdominal pain of 24 hours' duration and both ultrasonography and an upper GI series examination demonstrated a small tumorlike lesion in the second portion of the duodenum.
Abstract: To the Editor— The occasional association of von Recklinghausen's disease (VRD) with visceral tumors, such as neurofibromas, meningiomas, gliomas, and pheochromocytomas, is well documented 1 ; however, its association with gastrointestinal (GI) carcinoids is limited to only a few case reports 1,2 The purpose of this letter is to document further this association Report of a Case— A 53-year-old woman with VRD since adolescence was admitted to the hospital for right-sided upperquadrant abdominal pain of 24 hours' duration Physical examination showed several fleshy pedunculated cutaneous tumors, cafe-au-lait skin lesions, and a right-sided peroneal palsy Moderate right-sided upper quadrant abdominal tenderness and guarding were observed Total serum bilirubin value was 19 mg/dL (normal, 02 to 10 mg/dL) and serum alkaline phosphatase value, 129 units mU/ mL (normal, 30 to 105 mU/mL) Both ultrasonography and an upper GI series examination demonstrated a small tumorlike lesion in the second portion of the duodenum Exploratory
Journal Article•
TL;DR: The authors advocate an aggressive approach to establish biliary drainage in the presence of acute cholangitis or biliary cirrhosis in patients with a history of chronic, relapsing pancreatitis and abdominal pain.
Abstract: A syndrome of distal common bile duct obstruction secondary to the fibrotic effects of chronic pancreatitis has been recognized for some time. A group of ten characteristic patients, seven of whom have undergone surgery, is discussed. The diagnostic techniques and surgical procedures are presented, and the results are analyzed. Three patients with the syndrome were not operated upon and one improved spontaneously. The typical patient was a male alcoholic, average age 48 years, with a history of chronic, relapsing pancreatitis and abdominal pain. The most consistently abnormal laboratory value is a markedly elevated alkaline phosphates level. Endoscopic retrograde pancreaticocholangiography and transhepatic cholangiography are the most useful diagnostic procedures. Fifteen per cent of the most useful diagnostic procedures. Fifteen per cent of the patients operated upon required emergent surgery for acute cholangitis and sepsis. Another 29 per cent required prompt intervention for progressive hepatic failure secondary to biliary cirrhosis. The authors advocate an aggressive approach to establish biliary drainage in the presence of acute cholangitis or biliary cirrhosis. If a dilated pancreatic duct can be demonstrated and abdominal pain is the principal problem a direct procedure on the pancreas is needed.
TL;DR: In patients who have a very low likelihood of potentially serious disease, it may be useful to regard "nonspecific abdominal pain" as a positive diagnosis, rather than a diagnosis of exclusion, according to a diagnostic strategy for evaluating abdominal pain.
Abstract: The purpose of this study was to identify clinical characteristics that could predict the diagnosis in ambulatory patients with abdominal pain. We studied 552 unselected ambulatory male patients whose average age was 47 years and whose median duration of pain was 3 weeks. Potentially serious disease occurred in 21% of the patients. Single abnormal findings had a low predictive value for serious disease. However, by using combinations of clinical findings, we could construct and test a decision rule to identify a group of patients who had a low prevalence of serious disease. This "low risk" group contained 36% of all patients with abdominal pain. Laboratory tests were almost always normal in these patients. Our findings suggest a diagnostic strategy for evaluating abdominal pain: When the initial examination shows that there is little chance of serious disease, laboratory tests should be deferred or omitted altogether. In patients who have a very low likelihood of potentially serious disease, it may be useful to regard "nonspecific abdominal pain" as a positive diagnosis, rather than a diagnosis of exclusion.
01 Jan 1981
TL;DR: In this paper, the authors present a two-stage clinical investigation of chronic pain in women with chronic pelvic pain, including the following: 1.1.1 Prolapse, 2.2.3 Hyperalgesia of the Abdominal Wall and 3.3.4.
Abstract: 1 Introduction.- 1.1 Frequency of Chronic Pain.- 1.2 Frequent Incorrect Diagnoses.- 1.3 Two-Staged Clinical Investigation of Chronic Pain Syndromes.- 2 Anatomy and Physiology of Gynecologic Pain.- 2.1 Innervation.- 2.2 Central Pathways and Modulating Influences.- 2.3 Sensitivity of the Genital Organs.- 3 General Characteristics of Chronic Pain of Gynecologic Origin.- 3.1 Most Frequent Localizations.- 3.2 Radiation or Spread of Pain.- 3.3 Time-Intensity Relationship During the Menstrual Cycle.- 3.4 Hyperalgesia of the Abdominal Wall and of Back in Chronic Pain Syndromes.- 3.5 Other Useful Data.- 4 Examination of Patients with Chronic Pain Syndromes.- 4.1 The Patient and Her Complaints.- 4.2 Clinical Examination and Some Special Explorations.- 4.2.1 History of the Present Disorder.- 4.2.2 Somatic Examination.- 4.2.3 Some Special Explorations.- 4.3 Gynecologic Laparoscopy.- 4.3.1 Systematic Visual Exploration of the Pelvis.- 4.3.2 Indications.- 4.3.3 Contraindications.- 4.4 Interpretation of Data: Some Causes of Diagnostic Errors.- 5 Psychological Aspects of the Pain Experience.- 5.1 General Considerations.- 5.2 Behavioral Patterns of Patients with Acute and Chronic Pain.- 5.3 Presentation of the Pain Complaint.- 5.3.1 Verbal Presentation.- 5.3.2 Indications Suggesting Psychogenic Components in Pain Complaints.- 5.3.3 Main Psychopathologic Syndromes Inducing or Accompanying Gynecologic Pain Complaints.- 6 Genital Prolapse and Retroversion of the Uterus.- 6.1 Genital Prolapse.- 6.1.2 Pain Mechanisms.- 6.2 Retroversion and Retroflexion of the Uterus.- 6.2.1 Which Symptoms May Be Caused by Mobile Retroversion?.- 6.2.2 Treatment of Mobile Retroversion.- 6.2.3 Fixed Retroversion.- 7 Parietal Pain.- 7.1 Possible Causes of Pain Arising in the Abdominal Wall.- 7.1.1 Posterior Columns and Posterior Horns.- 7.1.2 Posterior Roots and Spinal Ganglia.- 7.1.3 Peripheral Nerves.- 7.2 Meaning of Parietal Tenderness in Chronic Abdominal Pain Syndromes.- 7.3 Characteristics of Parietal Pain Due to Irritation of Peripheral Nerves of the Abdominal Wall.- 7.4 Some Examples of Parietal Pain in Gynecologic Practice.- 7.4.1 Pain Due to Irritation of the Posterior Roots and Ganglia.- 7.4.2 Pain Due to Irritation of Peripheral Nerves.- 7.5 Some Examples of Abdominal Parietal Pain in Obstetric Practice.- 8 Dysmenorrhea.- 8.1 Incidence.- 8.2 Classification.- 8.3 Primary Dysmenorrhea.- 8.3.1 Clinical Characteristics.- 8.3.2 Pathophysiology.- 8.3.3 Pathogenesis of Primary Dysmenorrhea.- 8.3.4 Management.- 8.4 Secondary Dysmenorrhea.- 8.4.1 Endometriosis.- 8.4.2 Adenomyosis.- 8.4.3 Fibroids.- 8.4.4 Obstructive Dysmenorrhea.- 8.4.5 Psychogenic Dysmenorrhea.- 9 Midcycle Pain.- 9.1 Severe Form.- 9.2 Less Severe Forms.- 9.3 Pathogenesis.- 9.4 Treatment.- 10 Premenstrual Tension.- 10.1 Symptoms.- 10.1.1 Signs.- 10.1.2 Prevalence.- 10.1.3 Pathophysiology.- 10.2 Pathogenesis.- 10.2.1 Premenstrual Tension and Personality.- 10.2.2 Hyperestrogenism or Deficient Luteal Function?.- 10.2.3 Hyperaldosteronism?.- 10.2.4 Does Prolactin Play a Role?.- 10.3 Treatment.- 10.3.1 General Remarks.- 10.3.2 Drug Treatment.- 11 Endometriosis.- 11.1 Incidence.- 11.2 Diagnosis.- Spontaneous Pain.- 11.3 Various Pain Localizations in Endometriosis.- 11.3.1 Visceral Pain.- 11.3.2 Parietal Pain.- 11.3.3 Referred Pain of Visceral Origin Somatic Pain Radiations.- 11.4 Mechanism of Pain Due to Endometriosis.- 11.4.1 Pain Mechanism.- 11.4.2 Why Do Some Lesions Remain Painless?.- 11.4.3 How to Know Whether a Pain Symptom Is Due to Endometriosis.- 11.5 Acute Pain Syndromes Due to Endometriosis.- 11.5.1 Intestinal Stenosis and Obstruction.- 11.5.2 Acute Pain Without Rupture of an Endometriotic Cyst.- 11.5.3 Acute Pain Syndromes Due to Rupture of an Endometriotic Cyst.- 11.5.4 Pseudoappendicitis.- 11.5.5 Pseudoinflammatory Variety.- 11.6 Management of Endometriosis.- 12 Chronic Pelvic Inflammatory Disease.- 12.1 Chronic Parametritis Due to a Chronic Cervical Infection.- 12.2 Chronic Salpingo-Oophoritis.- 12.2.1 Tuberculous Salpingitis.- 12.2.2 Sequelae of Acute PID or "Chronic Salpingo-Oophoritis".- 12.2.3 Subacute and Recurrent Salpingo-Oophoritis.- 13 Ovarian Pain.- 13.1 Ovarian Cysts.- 13.1.1 Follicle Cysts.- 13.1.2 Lutein Cysts.- 13.1.3 Endometriotic Cysts.- 13.1.4 "Sclerocystic Ovaritis".- 13.1.5 Recurrent Functional Ovarian Cysts.- 13.2 Ovarian Remnant Syndrome.- 13.3 Residual Ovary Syndrome.- 13.4 Chronic Oophoritis and Perioophoritis.- 13.5 Ovarian Dyspareunia.- 13.6 Ovarian Tumors.- 13.7 Some Rare Causes of Ovarian Pain.- 14 Dyspareunia.- 14.1 Varieties of Dyspareunia.- 14.2 Superficial Dyspareunia.- 14.2.1 Tender Episiotomy Scars.- 14.2.2 Posterior Repair Scars.- 14.2.3 Senile Atrophy.- 14.2.4 Perineal Endometriosis.- 14.3 Vaginal Dyspareunia.- Psychogenic Dyspareunia.- 14.4 Deep Dyspareunia.- 14.5 Psychological Factors.- 15 Acute and Chronic Lower Abdominal Pain of Enterocolic Origin.- 15.1 Innervation and Visceral Sensations.- 15.1.1 Innervation.- 15.1.2 Visceral Sensations.- 15.2 General Considerations of Enterocolic Pain.- 15.2.1 Visceral Pain.- 15.2.2 Somatic Pain.- 15.2.3 Referred Pain.- 15.2.4 Shifting Pain.- 15.3 Abdominal Pain Patterns.- 15.3.1 Location of Pain.- 15.3.2 Duration of Pain.- 15.3.3 Quality of Pain.- 15.4 Enterocolic Disorders Causing Lower Abdominal Pain.- 15.4.1 Irritable Bowel Syndrome.- 15.4.2 Infectious Diarrheas.- 15.4.3 Appendicitis.- 15.4.4 Diverticulitis.- 15.4.5 Inflammatory Bowel Disease.- 15.4.6 Obstruction.- 15.4.7 Tumors.- 15.4.8 Pelvic Abscess.- 15.4.9 Hernias.- 15.4.10 Intestinal Ischemia (Abdominal Angina).- 16 Low Back Pain in Women.- 16.1 Introduction.- 16.2 Definition of Low Back Pain.- 16.3 Medicosocial Importance of Low Back Pain.- 16.4 Origin of Low Back Pain.- 16.5 Investigation of Low Back Pain.- 16.5.1 History.- 16.5.2 Physical Examination.- 16.5.3 Roentgenologic Investigation.- 16.5.4 Special Investigations.- 16.6 Etiology of Low Back Pain.- 16.6.1 Congenital Anomalies.- 16.6.2 Growth Disorders.- 16.6.3 Traumatic Lesions of the Vertebral Column.- 16.6.4 Inflammation.- 16.6.5 Tumors.- 16.6.6 Osteoporosis.- 16.6.7 Postdiskectomy Syndrome.- 16.6.8 Degenerative Changes in the Spine.- 16.6.9 Spinal Stenosis.- 16.6.10 Pathologic Changes in the Sacroiliac Joints.- 16.6.11 Coccygodynia.- 16.6.12 Pubic Symphysis Pain.- 16.7 General Rules of Treatment and Conduct for Patients with Back Complaints.- 17 Chronic Pelvic Pain of Urologic Origin.- 17.1 Introduction.- 17.2 Recurrent Cystourethritis.- 17.3 Intractable Suprapubic Pain Due to Infiltrating Bladder Tumors.- 17.4 Pelvic Kidney Ectopia.- 17.5 Nephroptosis.- 17.6 Ureteral Causes of Pelvic Pain.- 17.6.1 Congenital Ureteral Obstructions.- 17.6.2 Acquired Ureteral Obstructions.- 18 Chronic Pelvic Pain Without Obvious Pathology.- 18.1 Introduction.- 18.2 Description of the Syndrome.- 18.3 Prevalence.- 18.4 Pathogenesis.- 18.4.1 To What Extent Is CPPWOP Due to "Traumatic Laceration of Uterine Support"?.- 18.4.2 Role of Circulatory Disturbances in the Pathogenesis of CPPWOP.- 18.4.3 To What Extent Can the Syndrome Be Explained by Morphological or Functional Modifications in the Internal Genital Organs or in the Parametrium?.- 18.4.4 Psychological Characteristics of Women with CPPWOP.- 18.4.5 A Hypothesis Concerning the Pathogenesis of CPPWOP.- 18.5 Therapeutic Strategy.- 18.5.1 Establishing an Efficient Therapeutic Relationship.- 18.5.2 Psychological Evaluation and Treatment.- 18.5.3 Medical Treatment.- 18.5.4 Surgical Treatment.- 19 Treatment of Pain Due to Gynecologic Tumors Localized in the Pelvis.- 19.1 Introduction.- 19.2 Treatment of Cancer Pain with Analgesic Drugs.- 19.2.1 Pharmacologic Properties of Analgesic Drugs.- 19.2.2 Clinical Aspects of Cancer Pain.- 19.2.3 Therapeutic Use of Analgesic Drugs.- 19.2.4 Concomitant Medication.- 19.2.5 Mode of Administration.- 19.2.6 Side Effects.- 19.3 Treatment of Cancer Pain with Nerve Blocks.- 19.3.1 Midline Pain.- 19.3.2 Unilateral Pain.- 19.4 Neurosurgical Treatment of Cancer Pain of Gynecologic Origin.- 19.4.1 Lesion Techniques.- 19.4.2 Stimulation Techniques.- 19.5 Conclusion.- 20 Subject Index.
TL;DR: The early clinical features, primary care, treatment and short-term prognosis in 15 cases of acute myocarditis where diagnostic confirmation was made by endomyocardial biopsy or autopsy were analyzed and diagnostic criteria based upon the own experience have been constructed as a proposal.
Abstract: The early clinical features, primary care, treatment and short-term prognosis in 15 cases of acute myocarditis where diagnostic confirmation was made by endomyocardial biopsy or autopsy were analyzed. Characteristically, idiopathic myocarditis of possible viral etiology revealed preceding symptoms which consisted of flu-like symptoms, i.e., fever, upper respiratory infection (sore throat, cough), myalgia or arthralgia, general malaise, and gastrointestinal disorders (vomiting, anorexia, nausea, abdominal pain and soft stool). A severe cardiac or generalized disease condition may follow. Depending upon the progress of intensive medical and cardiac care, the patients' prognosis is not always poor. Diagnostic criteria based upon our own experience have been constructed as a proposal.
Journal Article•
TL;DR: Discrete colon ulcers should be considered in the differential diagnosis when the hemodialysis or kidney transplant patient presents with lower gastrointestinal bleeding or abdominal pain and peritoneal signs.
TL;DR: The disease is an endocrine emergency which requires prompt surgery after rapid correction of dehydration and hypercalcemia and the best results are achieved by removing offending parathyroid tissue within 72 hours after the onset of symptoms.
Abstract: Hyperparathyroid crisis is a rare disease but should be suspected in acutely ill patients complaining of weakness, lethargy, nausea, vomiting, confusion and abdominal pain. Despite the variety of clinical manifestations, the syndrome forms a distinctive pattern which, in the presence of a serum calcium level greater than 16 mg/100 ml, should be recognized. The most difficult problem in diagnosis is the differentiation of hyperparathyroid crisis from ectopic parathyroid hormone-producing tumors. The disease is an endocrine emergency which requires prompt surgery after rapid correction of dehydration and hypercalcemia. The best results are achieved by removing offending parathyroid tissue within 72 hours after the onset of symptoms.
TL;DR: The irritable bowel syndrome is clinically characterized by a wide variety of symptoms, including dyspepsia, flatulence, nausea, cramping abdominal pain, constipation and/or diarrhea, and nonspecific symptoms, probably reflecting autonomic nervous system overreactivity.
Abstract: The irritable bowel syndrome (IBS) is clinically characterized by a wide variety of symptoms, including dyspepsia, flatulence, nausea, cramping abdominal pain, constipation and/or diarrhea, and nonspecific symptoms, probably reflecting autonomic nervous system overreactivity. Physiologically, the colonic motor abnormality is characterized by an altered slow-wave rhythm, quantitative differences from normal in the repetitive contraction pattern of the rectosigmoid area, and increased colonic muscle responsiveness to hormones such as cholecystokinin and pentagastrin. The diagnosis of IBS involves practical and ethical considerations as well as the need for decisive reassurance of the patient through judicious examination. Treatment of IBS requires a thoughtful and sensitive approach to the patient, recognition of IBS as an important clinical problem, regularization of bowel function, relief of the abdominal discomfort, and intelligent emotional support.