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Abdominal Pain in the Elderly

Huai-Jin Li, Chun-Jing Li, Xiao-Na Wei, Jian Hu, Dong-Liang Mu, Dong-Xin Wang
BACKGROUND: Dexmedetomidine in combination with opioids has been used for postoperative analgesia. The purpose of this study was to investigate the impacts of dexmedetomidine supplemented intravenous analgesia on morphine consumption and subjective sleep quality in elderly patients after open abdominal surgery. METHODS: This was a pilot randomized controlled trial. 58 elderly patients (age ≥ 60 years) who underwent open abdominal surgery were randomized to receive either dexmedetomidine supplemented morphine analgesia (0...
2018: PloS One
Helena Moreira Silva, Gisela Silva, Emília Costa, Rosa Lima, Fernando Pereira
We describe the case of a previously healthy 8-year-old girl presenting with a 1-year history of iron deficiency anemia. There was no report of hematemesis, abdominal pain or melena. Laboratory work-up excluded iron malabsorption as the underlying cause. Therefore, endoscopic evaluation was performed to exclude gastrointestinal blood loss, which revealed the presence of a 7 mm reddish lesion located within the ampulla of Vater. Capsule endoscopy excluded alternative diagnoses and concomitant lesions. Histopathological examination confirmed the diagnosis of pyogenic granuloma...
August 9, 2018: Clinical Journal of Gastroenterology
Fabiola Aguilera, Tajudeen O Dabiri, Daniel T Farkas
Perforation of the gastrointestinal tract may present with abdominal pain and imaging demonstrating pneumoperitoneum. These findings usually require exploratory laparotomy for diagnosis and treatment. Tubo-ovarian abscess (TOA) is a complication of pelvic inflammatory disease presenting as an encapsulated inflammatory mass, but it can occasionally involve other pelvic organs. TOA is most commonly seen in females of reproductive age. Here we report a case of a 63-year-old female presenting with abdominal pain, fever and vomiting...
August 2018: Journal of Surgical Case Reports
Yuichi Sumii, Kazuhiko Yamamoto, Yasushi Omura, Wakako Oda, Eisei Kondo, Tadashi Oyama, Chihiro Kamoi, Yutaro Shiraishi, Yoshikazu Yamamoto, Daigo Niiya, Yasuhiro Shiote, Kenji Imajo
A 73-year-old male with melena was admitted to our hospital. Computed tomography (CT) scan revealed the thickening of the jejunal and ileal walls and swelling of the mesenteric lymph nodes. Type II enteropathy-associated T-cell lymphoma (EATL) was diagnosed based on the pathological analysis of the resected specimen. Positron emission tomography and CT scan showed complete remission (CR) after surgery, and he further received CHOP therapy. However, 2 months after the completion of the therapy, the patient's disease relapsed, and he presented with abdominal pain...
2018: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
Huei-Wen Lim, Benny Yiu Wong, David Elkowitz, Keith Sultan
An 85-year-old woman presented with 9.1 kg (20 lb) weight loss over 5 months and an acute onset crampy abdominal pain. Examination revealed a diffusely tender abdomen, with gastric wall thickening noted on CT scan. Upper endoscopy showed diffuse severe erythema and friability. Histologic examination with hematoxylin and eosin staining revealed collagenous gastritis characterized by active chronic inflammation with sub-epithelial collagen deposition and erosion. The patient was started on steroid therapy with rapid clinical improvement and tapered off over 2...
August 2018: Therapeutic Advances in Chronic Disease
Huaqi Cai, Fei Fu, Yang Wang, Jinbao Li, Jianpeng Cao, Mei Huang, Sipin Luo, Xiaochen Wei, Yeda Wan
OBJECTIVE: To investigate the correlation between the stenosis degree of superior mesenteric artery (SMA) and each artery within the scope of aorto-iliac artery in patients with lower extremity atherosclerotic occlusive disease (LEAOD). METHODS: Images of 70 patients who had undergone the aorta-iliac-femoral arteries CT angiography (CTA) examination and had a definite diagnosis of LEAOD due to intermittent claudication or resting pain admitted to Tianjin Hospital from January to December in 2017 were enrolled...
July 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Apichat Kaewdech, Pimsiri Sripongpun
Phlegmonous proctitis is a rare condition; it was first described in 1940. We report the case of an elderly woman who presented with acute severe lower abdominal pain, tenesmus, and fever. A computed tomography of the whole abdomen revealed a long segment of circumferential wall thickening of the rectum and rectosigmoid colon. Colonoscopy was done subsequently and showed marked edematous and erythematous rectal mucosa. When rectal tissue biopsy was performed, a large amount of pus came out at the biopsy site, which led to the diagnosis of phlegmonous proctitis...
May 2018: Case Reports in Gastroenterology
George Ramsay, Jared M Wohlgemut, Jan O Jansen
BACKGROUND: The provision of emergency general surgery services is a global issue, with important implications for patients and workforce. The aim of this study was to analyze the characteristics of emergency general surgical patients in the United Kingdom, with reference to diagnostic case mix, operative workload, comorbidity, discharge destination, and outcomes, in order to facilitate comparisons, and future service development. METHODS: This is a cross-sectional, population-based study based in the National Health Service (NHS) in Scotland, one of the home nations of the United Kingdom...
July 17, 2018: Journal of Trauma and Acute Care Surgery
Nu Ri Jang, Dae Hyung Lee, Eun Jung Jang, Young Kyung Bae, Jina Beak, Min Hye Jang
Gynandroblastoma is an extremely rare sex cord-stromal tumor with both female (granulosa cell tumor) and male (Sertoli-Leydig cell tumor) elements. Juvenile granulosa cell tumors are also very rare and are so named because they usually occur in children and adolescents. A 71-year-old woman with right upper quadrant abdominal pain visited our hospital. Pelvic computed tomography showed a large multilocular cystic mass, suspected to be of ovarian origin. We performed a total abdominal hysterectomy with bilateral salpingo-oophorectomy...
July 17, 2018: Journal of Pathology and Translational Medicine
Pınar Henden Çam, Ahmet Baydin, Savaş Yürüker, Ali Kemal Erenler, Erdinç Şengüldür
Introduction: The aim of this study is to detect the possible reasons of abdominal pain in the patients aged 65 and older admitted to emergency department (ED) with complaint of abdominal pain which is not related to trauma, to determine the length of hospitalization of old (65-75 age) and elderly (aged 75 and older) patients, and to define the hospitalization and mortality rates. Material and Methods: In the study, 336 patients were included. Groups were compared in respect to gender, internal or surgical prediagnoses, complaints accompanying abdominal pain, vital findings, comorbidities, requested consultations, hospitalizing service, waiting time in the ED and in the hospital, and treatment methods...
2018: Current Gerontology and Geriatrics Research
Vikarn Vishwajeet, Nirmalya Banerjee, Pranab Dey
Ovarian lipoleiomyoma is an extremely rare neoplasm and may pose a diagnostic challenge for clinicians, radiologists, and pathologists. It is rarely described as case reports in the literature; almost all patients are late middle aged or elderly. Hereby, we encountered a 57-yr-old postmenopausal woman who presented with abdominal pain. Radiologic investigation revealed a heterogenous nonenhancing mass in the left adnexa, suggestive of dermoid cyst. Microscopic examination showed clusters of adipocytes intersecting the fascicles of smooth muscles, diagnostic of lipoleiomyoma...
July 10, 2018: International Journal of Gynecological Pathology
Ali Bohlok, Melody El Khoury, Anne Bormans, Maria Gomez Galdon, Michael Vouche, Issam El Nakadi, Vincent Donckier, Gabriel Liberale
BACKGROUND: Schwannomas of the colon and rectum are rare among gastrointestinal schwannomas. They are usually discovered incidentally as a submucosal mass on routine colonoscopy and diagnosed on pathologic examination of the operative specimen. Little information exists on the diagnosis and management of this rare entity. The aim of this study is to report a case of cecal schwannoma and the results of a systematic review of colorectal schwannoma in the literature. MAIN BODY: PubMed, Scopus, and Cochrane database searches were performed for case reports and case series of colonic and rectal schwannoma...
July 3, 2018: World Journal of Surgical Oncology
Marta K Walczak-Galezewska, Damian Skrypnik, Monika Szulinska, Katarzyna Skrypnik, Pawel Bogdanski
RATIONALE: Acute calculous cholecystitis is a prevalent disease whose diagnosis and management still face significant debate. Although the overall incidence of gallstone disease is 18.8% in European women aged 30 to 69 years, there is little data and experience in managing acute calculous cholecystitis in populations over 80 years old. The incidence of acute cholecystitis among the elderly is probably increasing. For the reason, we here highlight the advantages and disadvantage of various treatment and management opens based on a 96-year-old patient...
June 2018: Medicine (Baltimore)
González-Urquijo Mauricio, Hinojosa-Gonzalez David Eugenio, Quevedo-Fernandez Enrique
Introduction: A cholecystocolonic fistula (CCF) is a late complication following repeated episodes of chronic inflammation of the gallbladder in contact with the hepatic flexure, and it might cause a biliary ileus in the colon, causing an intestinal obstruction, and if left untreated, a life threatening disease. Presentation of case: a 49-year-old female patient presented with abdominal pain and bowel obstruction due to a gallstone impaction on the sigmoid colon as consequence of a cholecystocolonic fistula...
July 2018: Annals of Medicine and Surgery
Khalid Muqueem, Somasekhar Kasa, Nagareddy Patil, Mohammed Minhajuddin Harsoori
Interstitial hernias are a rare subtype of abdominal hernias, where sac is present in between the abdominal wall layers. Although, difficult to diagnose clinically, they are usually detected on imaging studies. Interstitial hernias presenting with undescended testis are common. Even after a meticulous online search of the medical literature, we could not find a case report of 'Strangulation of Interstitial hernia, with a strangulated undescended testis in an elderly man. We hereby present this extremely rare case, and possibly, this could be the first of its kind, case report in the medical literature...
April 2018: Indian Journal of Surgery
Suqiao Zhang, Rui Lian, Guoqiang Zhang
RATINALE: Penetrating aortic ulcer (PAU) and rupture of a superior mesenteric artery branch is a rare but potentially life-threatening condition. PATIENT CONCERNS: We describe a case of 73-year-old man was brought to our Emergency Department for intermittent back pain. DIAGNOSES: The final diagnoses are PAU (Stanford B) and rupture of a branch of the superior mesenteric artery. INTERVENTIONS: Two covered stents were placed in the thoracic aorta and the right external iliac artery, and the superior mesenteric artery branch was embolized...
June 2018: Medicine (Baltimore)
Lucia Petrucci, Serena Monteleone, Susanna Ricotti, Erica Giromini, Mariangela Gullace, Emilia Ambrosini, Giorgio Ferriero, Elena Dalla Toffola
BACKGROUND: Increased life expectancy and improved surgical techniques have led to a sharp rise in healthcare resource consumption by older patients. In these patients early recovery of walking ability after abdominal surgery may shorten length of hospital stay and reduce overall healthcare costs, but it is important to understand what factors determine this recovery. AIM: To assess preoperative and postoperative determinants of walking ability recovery after major abdominal surgery in older patients...
June 11, 2018: European Journal of Physical and Rehabilitation Medicine
Tzu-Chieh Lin, Chung-Lin Tsai, Yao-Tien Chang, Sung-Yuan Hu
BACKGROUND: Primary aortoduodenal fistula (ADF) is a rare cause of gastrointestinal (GI) bleeding and is difficult to diagnose as the clinical presentation is subtle. Clinicians should keep a high level of suspicion for an unknown etiology of GI bleeding, especially in older patients with or without abdominal aortic aneurysm (AAA). Computed tomographic angiography (CTA) can be used to detect primary ADF. Open surgery or endovascular aortic repair (EVAR) for ADF with bleeding will improve the survival rate...
June 7, 2018: BMC Cardiovascular Disorders
Onder Karabay, Mustafa Genco Erdem, Mustafa Hasbahceci
Partial necrosis of the cecum is a rare form of ischemic colitis with unknown etiology. A 68-year female patient was admitted due to a severe pain in the right lower quadrant of the abdomen for one week. One month ago, she had coronary artery bypass graft surgery with carotid endarterectomy. During physical examination, tenderness and rebound tenderness at the right lower quadrant were detected. Computed tomography showed a 7-mm tubular structure extending from the back of the cecum to the lower border of the liver...
June 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Belinda De Simone, Laura Alberici, Luca Ansaloni, Massimo Sartelli, Federico Coccolini, Fausto Catena
INTRODUCTION: Small bowel non Meckelian diverticulitis (SBNMD) is not so uncommon cause of admission in departments of emergency surgery. Our aim is to highlight signs and symptoms for early diagnosis and report proper surgical treatments. EVIDENCE ACQUISITION: The systematic review protocol was guided by the Preferred Reporting Items for Systematic Reviews and Meta-analyses Protocol (PRISMA-P). EVIDENCE SYNTHESIS: Twelve studies met our inclusion criteria...
May 24, 2018: Minerva Chirurgica
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