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Abdominal Pain in the Elderly

Chen-Hui Ni, Huan Li, Chuan-Bao Xia, Yang-Tian Chen
RATIONALE: The case of parasternal diaphragmatic hernia is relatively rare in adults. The best way for the treatment of diaphragmatic hernia is to receive operation, yet which surgical method is the best remains unclear. PATIENT CONCERNS: An elderly woman in the hospital was complaining about upper abdominal pain that was complicated by the parasternal diaphragmatic hernia. Such state was found accidentally in a car accident and diagnosed by a computed tomography (CT) scan...
December 2018: Medicine (Baltimore)
Muhammad Usman Tariq, Zubair Ahmad, Jamshid Abdul-Ghafar, Nasir Ud Din
Background: Serous cystadenomas of pancreas are rare benign epithelial neoplasms, which predominantly occur in the pancreatic body and tail of elderly females. Majority of these tumors have microcystic appearance. Macrocystic and solid variants have also been described. A number of more aggressive cystic pancreatic lesions are included in the differential diagnosis. Distinction from such lesions is important for optimal management. Objective: Our aim was to study the clinical and histological features of serous cystadenomas which would be helpful in making their correct diagnosis and understanding their behavior...
2018: Rare Tumors
C Sousa-Ribeiro, L N C Tavore, L Anjos-Ramos
Strongyloidiasis is an intestinal parasitosis that occurs in humans infected by Strongyloides stercoralis mostly. At its acute phase, symptoms like constipation, diarrhea and abdominal pain can be observed, but become asymptomatic for a long time, until an immunosuppression will start a hyperinfection and the dissemination of the disease, prevalent on the elderly population in tropical countries. Ivermectina treatment is the currently choice for this disease, due to its great efficacy and the results reported...
December 6, 2018: Acta Tropica
Albane de Thézy, Marie Simon, Pauline Jouët, Tristan Cudennec
There are numerous indications for gastrointestinal endoscopies in elderly people. These include notably bleeding of the digestive tract, unexplained anorexia, abdominal pain, a pathology of the colon or screening for cancerous lesions. These examinations are carried out by a multidisciplinary team. It is essential that the patient is informed as a certain amount of prior preparation is required to ensure the good quality of the examinations.
July 2018: Soins. Gérontologie
Manish P Shrestha, Sasha Taleban
The incidence rate of ulcerative colitis (UC) in older patients is rising. Diagnosis of UC may be difficult in older patients as several common gastrointestinal disorders can mimic UC in these patients. Compared with younger adults, left-sided colitis is more common in older-onset UC, while rectal bleeding, abdominal pain, and extraintestinal manifestations are less common. The disease course of older-onset UC may be similar to that of adult-onset UC. The management of UC in older patients includes medical and surgical options...
December 4, 2018: Drugs & Aging
Jaime A Cardona-Ospina, Carlos E Jiménez-Canizales, Heriberto Vásquez-Serna, Jesús Alberto Garzón-Ramírez, José Fair Alarcón-Robayo, Juan Alexander Cerón-Pineda, Alfonso J Rodríguez-Morales
The febrile patient from tropical areas, in which emerging arboviruses are endemic, represents a diagnostic challenge, and potential co-infections with other pathogens (i.e., bacteria or parasites) are usually overlooked. We present a case of an elderly woman diagnosed with dengue, chikungunya and Leptospira interrogans co-infection. Study Design: Case report. An 87-year old woman from Colombia complained of upper abdominal pain, arthralgia, myalgia, hyporexia, malaise and intermittent fever accompanied with progressive jaundice...
November 26, 2018: Tropical medicine and infectious disease
Paolo Ruscelli, Claudio Renzi, Andrea Polistena, Alessandro Sanguinetti, Nicola Avenia, Georgi Popivanov, Roberto Cirocchi, Massimo Lancia, Sara Gioia, Renata Tabola
RATIONALE: Retroperitoneal colonic perforation is a rare cause of retroperitoneal abscess. It presents, more frequently in frail elderly patients, with heterogeneous signs and symptoms which hamper the clinical diagnosis. Subcutaneous emphysema with pneumomediastinum and iliopsoas muscle abscess are unusual signs. Colonic retroperitoneal perforation may be consequent to diverticulitis or locally advanced colon cancer. Due to the anatomy of the retroperitoneal space and different physiopathology, diverticular perforation may present with air and pus collection; on the other hand perforated colon cancer may cause groin mass and psoas abscess...
November 2018: Medicine (Baltimore)
Hasan Calis
OBJECTIVE: To assess the factors affecting the morbidity and mortality in patients over 65 years of age who underwent appendectomy. STUDY DESIGN: An observational study. PLACE AND DURATION OF STUDY: Department of General Surgery, Faculty of Medicine, Ahi Evran University, Kirsehir, Turkey, from November 2014 to March 2017. METHODOLOGY: Medical records of the patients over 65 years of age with the diagnosis of acute appendicitis who underwent appendectomy during the study period were retrospectively analyzed...
November 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Kusay Ayoub, Nihad Mahli, M Fateh Dabbagh, Bashar Banjah, Bassel Banjah
Introduction: Although relatively rare, an obturator hernia is a significant cause of intestinal obstruction. It usually occurs in emaciated elderly females. Computed tomography is the imaging modality of choice to diagnose obturator hernias. Case report: In this report we present a case of an elderly female who presented to the emergency department with features suggesting bowel obstruction. The patient was admitted to the hospital and was initially managed conservatively...
December 2018: Annals of Medicine and Surgery
Ashraf F Hefny, Adel Z Ayad, Nikolay Matev, Masoud O Bashir
INTRODUCTION: Psyllium in granular dosage form is used as an over - the counter safe laxative drug. It has a considerable hygroscopic propriety which allows it to retain water and expands rapidly to become many times of its original size. PRESENTATION OF THE CASE: 21-year-old man presented to the Emergency Department complaining of lower abdominal pain and constipation for five days. He was discharged home on Psyllium for treatment of the constipation. Two days later, he returned to the Emergency Department complaining of increased abdominal distension without passing any stools...
2018: International Journal of Surgery Case Reports
Natalie Galanina, Razelle Kurzrock
BACKGROUND: The treatment of peripheral T-cell lymphoma (PTCL) after failure of standard therapy represents a significant clinical challenge as the best approach has not been defined. The outcomes of patients with peripheral T-cell lymphoma (PTCL) after relapse, in the absence of hematopoietic stem-cell transplantation, are poor with median overall survival is less than six months. Thus, relapsed/refractory PTCL presents an area of unmet medical need. CASE PRESENTATION: Herein, we report an 84-year old woman with stage IV PTCL with extensive involvement of the bowel and abdominal pain...
October 11, 2018: Cancer Biology & Therapy
Mayuko Hida, Takatoshi Anno, Fumiko Kawasaki, Hideaki Kaneto, Kohei Kaku, Niro Okimoto
BACKGROUND: Pyosalpinx, which is one of the pelvic inflammatory diseases, is usually observed in young women; it is rarely found in older women. Possible causative agents are thought to be Chlamydia trachomatis and Neisseria gonorrhea in addition to some Enterobacteriaceae. On the other hand, type 2 diabetes is a disease with a lot of complications such as hyperglycemia, inflammation, and immune disorders. Therefore, patients with type 2 diabetes mellitus have an increased susceptibility to infection especially when glycemic control is poor...
October 6, 2018: Journal of Medical Case Reports
Kemal Eyvaz, Hasan Ediz Sıkar, Mehmet Gökçeimam, Hasan Fehmi Küçük, Necmi Kurt
We would like to present the case of a 76-year-old female patient with cecal necrosis, which is a rare cause of acute abdomen in elderly women and a variant of ischemic colitis. The patient was admitted to our hospital with abdominal pain, anorexia, and nausea. Physical examination, laboratory parameters, and abdominal computed tomography revealed acute abdomen. We operated the patient with an infra-umbilical midline incision. Considering the pain localized to the right lower quadrant, our initial diagnosis was acute appendicitis; however, we kept in mind other differential diagnoses as well...
September 11, 2018: Turkish Journal of Surgery
Renee Meyer, Paul G Werthmann, Gunver S Kienle
BACKGROUND: Colonic diverticula develop in at least 60% of elderly patients. Less than 25% of these develop diverticulitis. Recurrent episodes are experienced by about 13% of the symptomatic patients. The effect on prevention of recurrent diverticulitis of currently used therapies is controversial. Surgical colon resection is used in some patients in emergency or to prevent future episodes and complications. Carpellum Mali comp. (Juglans regia, Testa; Pirus malus, Carpellum) and Kalium aceticum comp...
October 2018: Complementary Therapies in Medicine
Matei R Bratu, Bogdan Balmes, Bogdan I Diaconescu, Mircea Beuran
Among intestinal obstruction, intussusception is one of the rare mechanical causes in the adult period. When it is met it present with abdominal pain, vomiting and other symptoms compatible with intestinal obstruction varying on the segments being involved. Compared to pediatric invagination which it is mostly idiopathic the adult form has an organic etiology causing a blurred symptomatology and needing advanced imaging diagnosis like computerized tomography. We present the case of a 70 year old woman with multiple Emergency Department presentations with abdominal pain and vomiting which received a clear diagnosis only the third time she came to hospital...
July 2018: Chirurgia
Nooreen Hussain, Faiz Hussain, Tulika Chatterjee, Jan N Upalakalin, Teresa Lynch
Enteropathy-associated T-cell lymphoma (EATL) is a rare disease found in the small bowel and is seen most commonly in patients with refractory celiac disease (RCD). We present a case of an elderly male with celiac disease (CD) diagnosed in childhood with months of abdominal pain and diarrhea despite attempting to avoid gluten in his diet. After persistent symptoms for months, the patient was admitted for an acute abdomen and was found to have small bowel perforation due to a jejunal mass that was diagnosed as an EATL...
2018: Journal of Community Hospital Internal Medicine Perspectives
Bin Lu, Li-Li Niu, Xi-Guang Xu, Shu-Lan Yao, Xing-You Tan
RATIONALE: Ulcerative colitis (UC) is one of the chronic inflammatory diseases of the intestinal tract. UC being misdiagnosed as Henoch-Schönlein purpura (HSP) in the elderly has seldom been reported about. PATIENT CONCERNS: A 64-year-old man was admitted to the hospital with petechiae and palpable purpura in lower limbs and abdominal pain for about 1 month. DIAGNOSES: Colonoscopy demonstrated severe inflammation in the colon, mucosal congestion, and edema, and multiple hemorrhages and ulcerations, with purulent adhesions...
August 2018: Medicine (Baltimore)
Ewan D McNicol, McKenzie C Ferguson, Roman Schumann
BACKGROUND: Postoperative administration of non-steroidal anti-inflammatory drugs (NSAIDs) reduces patient opioid requirements and, in turn, reduces the incidence and severity of opioid-induced adverse events (AEs). OBJECTIVES: To assess the analgesic efficacy and adverse effects of single-dose intravenous diclofenac, compared with placebo or an active comparator, for moderate to severe postoperative pain in adults. SEARCH METHODS: We searched the following databases without language restrictions: the Cochrane Central Register of Controlled Trials (Cochrane Register of Studies Online), MEDLINE, and Embase on 22 May 2018...
August 28, 2018: Cochrane Database of Systematic Reviews
Zi'ang Zou, Songshu Xiao, Min Xue
We reported a case of giant solitary fibrous tumor of vagina and reviewed literature. The clinical features, diagnosis, and treatment schemes for the disease were summarized to improve the understanding of the disease. An elder female patient came to the Third Xiangya Hospital, Central South University, because of abdominal distention and pain for 5 days after menopause for 9 years. The patient was diagnosed as a solitary fibrous tumor of vagina by pathology and immunohistochemistry after complete resection...
July 28, 2018: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
Qian Zou, Lijuan Feng, Miao Ouyang
To explore the differences in biological characteristics for the small gastrointestinal stromal tumors and the incidence of complications and recurrence between the traditional surgical treatment and endoscopic treatment.
 Methods: We collected the relevant clinical and pathological data from patients who were diagnosed as gastrointestinal stromal tumors with the diameter less than 2 cm by the Department of Pathology of Xiangya Hospital from January 2009 to December 2015. The complications and recurrence after the surgical treatment were analyzed...
July 28, 2018: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
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