A rare case of abdominal pain (original) (raw)
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A Rare Cause of Recurrent Abdominal Pain
Middle East Journal of Digestive Diseases, 2015
A 30-year-old man presented with a nine-months history of repetitive abdominal pain simulating dyspepsia. Nine months before presentation, a local physician saw him, and he performed upper gastrointestinal endoscopy for him, and was diagnosed as a case of mild gastritis with oral omeprazole, but without any benefit. So the patient was seen at another center and was evaluated by abdominal computerized scan (CT scan) and colonoscopy which both of them were normal. The patient was evaluated and treated also by psychiatrist as a case of functional disease.
The unusual cause of recurrent abdominal pain in an 11-year-old boy
Nuclear medicine review. Central & Eastern Europe: journal of Bulgarian, Czech, Macedonian, Polish, Romanian, Russian, Slovak, Yugoslav societies of nuclear medicine and Ukrainian Society of Radiology
The case of an 11-year-old boy with recurrent abdominal pain is presented. Physiological findings were found normal during a clinical investigation, as well as many laboratory tests, ultrasonography and CT of abdomen. Only a high level of sedimentation rate and the focus of increased activity in the sacral region on scintigraphy using 99mTc-HMPAO (hexamethypropyleneaminooxime) labelled leukocytes were found. The other findings on bone scintigraphy, X-ray and MRI led to a deflection of the correct diagnosis. The real culprit proved to be an ingested foreign body (a piece of a wooden skewer) that the patient failed to reveal.
BMJ Case …, 2009
Karakoc, Sinan Cumhur; Yetkin, Gürkan; Citgez, Bülent; Uludağ, Mehmet; Akgün, Ismail; Kartal, Abdulcabbar.
A 7-Year-Old Boy With Recurring Episodes of Abdominal Pain
Pediatric Emergency Care, 2020
Recurrent abdominal pain is a relatively common complaint in children who present to the emergency department. The etiology is often thought to be psychogenic, with an underlying organic cause present in less than 10% of patients. Intermittent ureteropelvic junction obstruction is usually not considered in the differential diagnosis of recurrent acute abdominal pain in children, which can cause a significant delay in diagnosis. In this condition, intermittent obstruction of the flow of urine from the renal pelvis to the proximal ureter occurs, which causes intermittent acute colicky abdominal pain and vomiting. This acute event, often referred to as a Dietl's crisis, either subsides after several hours or prompts a visit to the emergency department. Management often focuses on the identification of psychosocial issues or constipation, and routine abdominal imaging is not a common practice. The frequency of these events over time and the duration of each acute event are 2 components that factor into determining the loss of function in the affected kidney. The purpose of this case report is to increase awareness of intermittent ureteropelvic junction obstruction as a cause of recurring episodes of acute abdominal pain in children. Emphasis in this case report is on Dietl's crisis, how it presents, and how it is diagnosed and managed.
A Common Disease With an Unusual Complication of Acute Abdomen
Gastroenterology, 2012
Question: A previously healthy 64-year-old man presented to the emergency department with a 4-day duration of progressive and diffuse abdominal pain. The pain, seemingly unrelated to meals or postural change, began with intermittent cramps and progressed to a steady, constant ache. Physical examination revealed marked lower quadrant tenderness, diffuse peritoneal sign, and reduced bowel sounds. Deep tenderness at McBurney's point was not obvious. Laboratory investigation disclosed leukocytosis with a left shift, and the remaining tests were unremarkable. Contrast-enhanced computed tomography (CT) was performed (Figure A). What is your diagnosis and management? See the GASTROENTEROLOGY web site (www.gastrojournal .org) for more information on submitting your favorite image to Clinical Challenges and Images in GI.
A patient with recurrent acute abdominal pain
Postgraduate Medical Journal, 1999
A 48-year-old Jewish woman presented to the emergency room complaining of sharp epigastric abdominal pain of acute onset. The pain was non-radiating and severe in intensity and had started 6 hours prior to presentation. It was associated with nausea and vomiting. The vomitus consisted of food particles. She denied complaints of diarrhoea, constipation, melaena, haematemesis or weight loss. The physical examination revealed a blood pressure of 110/64 mmHg, pulse rate 60 beats/min, temperature 38.2°C, and a respiratory rate of 16 breaths/min. She weighed 48 kg. She was anicteric and had no cervical lymphadenopathy. The abdomen was soft and diVusely tender. Rigidity, rebound tenderness, hepatosplenomegaly or masses were absent. Rectal examination showed guaiac-negative brown stool. The remainder of the examination was unremarkable. The patient was not taking any medications and denied use of alcohol, tobacco or intravenous drugs. Her diet consisted mainly of low fat vegetarian food products. Her family history was unremarkable. A review of patient's medical records showed documentation of similar episodes on at least six occasions over the previous 18 months. During the attacks, the pain lasted 48 to 72 hours and was associated with a low-grade fever (37-38.5°C). Medical history was significant for long-standing back pain and degenerative joint disease involving the knees (for at least 15 years). There was a history of self-limited episode of viral meningitis 1 year prior to presentation. She had undergone tubal ligation 10 years prior to the onset of abdominal pain, followed by a laparotomy 6 years later for evaluation of pelvic pain. Adhesions were discovered during the laparotomy. The investigative work-up failed to reveal a definite diagnosis. On numerous occasions, laboratory data including complete blood count, erythrocyte sedimentation rate, and routine blood chemistry were within normal limits, except for minimal elevation of white blood cell count on two occasions. Antinuclear antibody assay was negative. Abdominal ultrasound and a HIDA scan did not reveal any abnormalities. Abdominal X-ray, upper gastrointestinal barium study, and a colonoscopy were normal. Computed tomography of the abdomen and pelvis was unremarkable. The patient was admitted to the hospital for observation, as diagnostic studies were unrevealing. She became asymptomatic within 24 hours and was discharged home. Questions 1 What is the diagnosis ? 2 Describe the pathogenesis of this clinical condition ? 3 How was the diagnosis made ? 4 Describe the most recent development in the diagnosis of this condition ? 5 What is the treatment ?
Abdominal pain in a 7-year-old male
2019
A 7-year-old male presented with abdominal pain of one day duration. An ultrasound (US) diagnosis reported atypical ileocolic intussusception and adjacent hypoechoic nodes, suggesting a possible lead point. Computed Tomography (CT) scan was performed for further investigation ( Figs. 1-2 ). Following a failed fluoroscopic reduction, an ileocolic intussusception was surgically reduced without visible or palpable external macroscopic bowel abnormality. Biopsy of a mesenteric node came back as hyperplasia. Patient’s postoperative US by an inexperienced operator was unrevealing. Four months later the patient presented with abdominal distention and palpable abdominal masses. A repeat CT scan was performed ( Figs. 3-6 ).
An unusual case of abdominal pain
British Journal of Radiology, 2010
Renal calyceal rupture is a usual etiology of abdominal pain in the emergency department. We present a case of unexpected renal calyx rupture in a patient with symptomatology of renal colic. A discussion and review are provided.
Recurrent abdominal pain and ascites in an adolescent
The Journal of Pediatrics, 1988
A 15-year-old boy was admitted to Hartford Hospital for evaluation of ascites and chronic abdominal pain. He had been in good health until age 12 years, when he developed recurrent episodes of periumbilical abdominal pain. The discomfort was described as crampy and unassociated with eating, any particular activity, or time of day. The cramps would last for several minutes and then subside. Several episodes of cramping would occur over a period of 1 to 2 weeks, then remit for several months. The patient had no diarrhea, vomiting, fever, fatigue, rashes, or weight loss during the episodes of pain. Clinical diagnoses of viral syndrome, irritable bowel syndrome, and peptic ulcer had been made.