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Elderly abdominal pain

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https://www.readbyqxmd.com/read/28207574/laparoscopic-and-open-surgical-treatment-in-gastroduodenal-perforations-our-experience
#1
Rita Laforgia, Giovanni Balducci, Giuseppe Carbotta, Antonio Prestera, Maria Grazia Sederino, Giulia Casamassima, Marina Minafra, Pierluca Sallustio, Nicola Palasciano
INTRODUCTION: Peptic ulcer perforation (PPU) is a common surgical emergency and the mortality rate ranges 10% to 40%, especially in elderly patients. Laparoscopic repair achieved encouraging results. MATERIALS AND METHODS: We enrolled patients performing surgical repair for PPU from January 2007 to December 2015 in our surgical unit. The aim of this retrospective observational study was to compare the results of PPU laparoscopic repair with open technique. The following characteristics of patients were evaluated: age, sex and American Society of Anesthesiologists classification...
February 15, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28202890/a-case-of-upside-down-stomach-that-was-effectively-treated-by-postprandial-repositioning
#2
Kazumasa Ono, Hiroshi Hasegawa, Toshimasa Obara, Kei Miyagishima, Shinichiro Inoue, Koichi Kozaki
An 88-year-old woman with a history of stomach perforation and lumbar compression fracture was admitted to our hospital with a chief complaint of continuous vomiting, which she had experienced since the previous day. She showed vomiting, spontaneous pain and tenderness from the epigastric fossa through the left flank. In addition, she had marked kyphosis. On a CT scan, although the fornix was located in the abdominal cavity, the antrum and body had escaped into the thoracic cavity. A large volume of gastric content was observed...
2017: Nihon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
https://www.readbyqxmd.com/read/28174414/a-case-of-henoch-schonlein-purpura-associated-with-rotavirus-infection-in-an-elderly-asian-male-and-review-of-the-literature
#3
Chen Tang, Daphne Scaramangas-Plumley, Cynthia C Nast, Zab Mosenifar, Marc A Edelstein, Michael Weisman
BACKGROUND Henoch-Schönlein purpura (HSP), a small vessel vasculitis mediated by deposition of immune-complexes containing IgA in the skin, gut, and glomeruli, often presents with abdominal pain, purpuric rash in the lower extremities and buttocks, joint pain, and hematuria. The disease most commonly targets children but can affect adults who tend to have a worse prognosis. CASE REPORT We discuss a case of HSP in an elderly Chinese male who presented with severe proximal bowel inflammation, vasculitic rash, and proteinuria; he was found to have positive stool rotavirus and giardia...
February 8, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28162180/-an-analysis-of-clinical-characteristics-of-twelve-cases-of-mesenteric-panniculitis
#4
Q W Jiang, F D Wang, W Z Wang, X Wu, H J Shu, J N Li, A M Yang, J M Qian, D Wu
Objective: Mesenteric panniculitis is an idiopathic, uncommon disease involving the adipose tissue of mesentery. The etiology, diagnosis and treatment are still unnoticed. We thus reported a case series to improve the understanding of this rare disorder. Methods: We retrospectively analyzed the clinical data of 12 patients with mesenteric panniculitis including manifestation, diagnosis, treatment and prognosis. Results: We found a male predominance (M∶F 3∶1) with the median age of 58 years old at diagnosis...
February 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/28143418/reactivated-cytomegalovirus-proctitis-in-an-immunocompetent-patient-presenting-as-nosocomial-diarrhea-a-case-report-and-literature-review
#5
Chun-Yuan Lee, Yen-Hsu Chen, Po-Liang Lu
BACKGROUND: Reactivated cytomegalovirus (CMV) infection has been known to cause significant morbidity and mortality in immunocompromised patients. However, CMV disease rarely develops in immunocompetent patients, and reported cases often present with a mild, self-limiting course, without severe life-threatening sequelae. While the colon is the most common gastrointestinal site affected by CMV disease in immunocompetent patients, rectal involvement is rarely reported. CMV proctitis can present in two distinct forms, primary and reactivated...
February 1, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28138407/the-value-of-ultrasonography-in-the-diagnosis-of-varicocele
#6
REVIEW
Tomasz Lorenc, Leszek Krupniewski, Piotr Palczewski, Marek Gołębiowski
A varicocele is described as pathologically enlarged, tortuous veins of the pampiniform plexus, leading to an increased testicular temperature and adrenal metabolite reflux into the testes. Varicocele can impair spermatogenesis and is considered to be the most common cause of male infertility. Patients may palpate a thickening in the scrotum or complain of dull scrotal or inguinal pain, which increases when standing or during erection. In the case of a sudden onset of varicocele in elderly men, it is necessary to exclude renal tumor and extend diagnostic ultrasound with the assessment of the abdominal cavity...
December 2016: Journal of Ultrasonography
https://www.readbyqxmd.com/read/28129607/a-rare-case-of-jejunogastric-intussusception-following-gastric-surgery
#7
Yash Vaidya, Rajan Vaithianathan
INTRODUCTION: Jejunogastric intussusception (JGI) is an extremely rare complication of prior gastric surgery. Fewer than 200 cases have been reported in the literature. CASE PRESENTATION: We present a case of an elderly male who presented with typical abdominal pain, hematemesis and a palpable epigastric mass. Ultrasonography and upper endoscopy diagnosed jejunogastric intussusception. Emergent laparotomy with manual reduction of the efferent loop intussusception resulted in successful treatment...
January 10, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28089100/community-onset-clostridium-difficile-infection-at-a-tertiary-medical-center-in-southern-taiwan-2007-2015
#8
Chin-Shiang Tsai, Yuan-Pin Hung, Jen-Chieh Lee, Nan-Yao Lee, Po-Lin Chen, Ling-Shan Syue, Ming-Chi Li, Chia-Wen Li, Wen-Chien Ko
BACKGROUND: Clostridium difficile infection (CDI) is well-known as the major cause of infectious diarrhea in hospitalized patients. Community-onset CDI (CO-CDI) is an emerging threat. However, clinical information of CO-CDI in Taiwan remains scarce. METHODS: A retrospective study was conducted at a medical center in southern Taiwan. Symptomatic patients between 2007 and 2015 with C. difficile toxin or tcdB detected in stool were identified as CDI, and were classified as CO-CDI [including community-associated CDI (CA-CDI) and community-onset health care facility-associated CDI (CO-HCFA-CDI)] and health care facility-onset CDI (HCFO-CDI)...
December 18, 2016: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/28065611/-diet-and-lifestyle-rules-in-chronic-constipation-in-adults-from-fantasy-to-reality%C3%A2
#9
REVIEW
Nadia Fathallah, Dominique Bouchard, Vincent de Parades
Chronic constipation is one of the most common chronic gastrointestinal complaints and a frequent reason for consultation. Lifestyle modification and dietary advice attract a lot of patients, often dissatisfied with a long-term drug intake. These behavioral modifications are recommended as a first-line approach in the treatment of chronic mild constipation in the majority of current guidelines despite a low level of evidence. Fiber supplementation is probably the most relevant measure because of a satisfactory level of proof...
January 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28065368/a-randomised-clinical-trial-of-routine-versus-selective-ct-imaging-in-acute-abdomen-impact-of-patient-age-on-treatment-costs-and-hospital-resource-use
#10
Tiina T Lehtimäki, Hannu Valtonen, Pekka Miettinen, Petri Juvonen, Hannu Paajanen, Ritva Vanninen
OBJECTIVES: To evaluate the impact of patient age on hospital resource use and treatment costs of acute abdominal pain (AAP). MATERIALS AND METHODS: A total of 300 adult patients with AAP were randomised to either computed tomography (CT, n=150) or selective imaging practice (SIP, n=150) groups. Final analysis included 254 patients, 143 (42 patients ≥65years) in the CT and 111 (32 patients ≥65years) in the SIP group. All CT group patients underwent abdominal CT whereas in the SIP group, imaging was based on the clinical assessment...
February 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/27938535/coexisting-incarcerated-femoral-and-obturator-hernia-a-case-report
#11
C Santorelli, C A Leo, J D Hodgkinson, Paolo Rossi
BACKGROUND: Obturator hernia is a rare condition associated with a high morbidity and mortality. It is an uncommon cause of bowel obstruction most commonly described in elderly females with comorbidity. Surgical intervention is often delayed as a result of subtle presenting signs. Coexisting ipsilateral femoral hernia is an even rarer condition represented by non-exhaustive series in the literature. CASE PRESENTATION: We report a case of a healthy 36 years old lady, nulliparous, with abdominal pain and swelling in the right groin...
July 2016: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/27911458/spondylodiscitis-a-rare-complication-following-percutaneous-nephrostomy
#12
Francesco Chiancone, Maurizio Fedelini, Clemente Meccariello, Luigi Pucci, Marco Fabiano, Paolo Fedelini
Spondylodiscitis is an inflammation of the intervertebral disc and the adjacent vertebral bodies. The spondylodiscitis can not only be a complication of medical interventions such as an operation near spinal column but also urogenital and vascular interventions and intravenous catheter use. A 71-year-old man was admitted to our emergency department with fever and severe abdominal pain. Antibiotic therapy had been performed with intravenous administration of 2 g of ceftriaxone and the patient underwent the placement of a percutaneous nephrostomy according to Seldinger technique...
November 28, 2016: Urologia
https://www.readbyqxmd.com/read/27904124/mycotic-aneurysm-caused-by-bacteroides-fragilis-in-an-elderly-immunosuppressed-patient
#13
Takahiko Fukuchi, Sadao Kawasaki, Hiroki Hayashi, Daisuke Koreeda, Takahiro Ashikawa
An 82-year-old Japanese man, who presented with a fever and abdominal pain, was admitted to our hospital. According to enhanced computed tomography images, the probable diagnosis was abdominal aortic mycotic aneurysm. Eight sets of blood cultures obtained from the patient were negative. Despite administering treatment with vancomycin and ceftriaxone, the aneurysm progressively enlarged. He underwent open debridement surgery and in situ replacement because of an aneurysmal rupture. Bacteroides fragilis was isolated from the tissue culture of the aortic wall...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27893667/abdominal-compartment-syndrome-after-endovascular-repair-for-ruptured-abdominal-aortic-aneurysm-leads-to-acute-intestinal-necrosis-case-report
#14
Xiyang Chen, Jichun Zhao, Bin Huang, Ding Yuan, Yi Yang, Yukui Ma
INTRODUCTION: Abdominal compartment syndrome (ACS) after endovascular repair (EVAR) of rupture abdominal aortic aneurysm (rAAA) is a rare emergency situation, which has a high mortality. However, the progression of ACS is rapid and the diagnosis is usually been delayed, which increase the difficulties in treatment and affect the prognosis. We describe a case of a sever complication (acute intestinal necrosis) resulting from ACS after endovascular repair of rAAA. CLINICAL FINDING: An elderly man, 81 years old, complained a sudden lower abdominal and back pain without any predisposing cause...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27891381/post-colonoscopy-ischaemic-colitis-in-a-patient-without-risk-factors-for-colon-ischemia-a-case-report
#15
Dattatray Balasaheb Solanke, Nirav Madhukant Pipaliya, Alisha Nitin Chaubal, Meghraj Ananda Ingle, Prabha Dilip Sawant
Ischaemic colitis is the most common form of intestinal ischaemia and is more common in the elderly and in the people having risk factors for colonic ischaemia. Colonoscopy procedure itself is a rare cause of ischaemic colitis. Fewer than 20 cases of ischaemic colitis caused by colonoscopy procedure have been reported in the english literature till date. This patient presented to us within hours of routine colonoscopy with rectal bleeding and lower abdominal pain. On repeat colonoscopy, the patient had mucosal oedema and ulcerations in the descending colon and sigmoid colon...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27890894/clinical-complete-response-from-chemotherapy-in-an-elderly-patient-with-metastatic-gastric-cancer-a-case-report
#16
Tetsuro Kawagoe, Yuta Maruki, Hiroyuki Nagoya, Yuki Kosugi, Teppei Akimoto, Hiroshi Yamawaki, Yasuhiro Kodaka, Mayumi Shimpuku, Nobue Ueki, Seiji Futagami, Kazumasa Miyake, Katsuhiko Iwakiri
An 81-year-old man was admitted with upper abdominal pain and weight loss. Esophagogastroduodenoscopy revealed a large tumor located from the gastric angle to the body. Histological analysis of a biopsy revealed a moderately differentiated adenocarcinoma. Computed tomography revealed metastases in the liver and lung and the patient was subsequently diagnosed with metastatic advanced gastric cancer. He was treated with chemotherapy using S-1 (80 mg/m(2)) and cisplatin (CDDP) (60 mg/m(2)). Twenty-two months after chemotherapy, the gastric tumor, and the nodules in the liver and lung, had disappeared...
2016: Journal of Nippon Medical School, Nippon Ika Daigaku Zasshi
https://www.readbyqxmd.com/read/27837460/fixation-free-incisional-hernia-repair-in-the-elderly-our-experience-with-a-tentacle-shaped-implant
#17
Giorgio Romano, Pier Giorgio Calò, Enrico Erdas, Fabio Medas, Luca Gordini, Francesco Podda, Giuseppe Amato
BACKGROUND: Incisional hernia in aged patients represents a challenge even for experienced surgeons. Besides increased risk of complications due to comorbidities, mesh fixation and assuring a sufficient mesh overlap of the defect are the main issues in carrying out the repair. AIMS: In order to assure broader coverage of the abdominal wall and a tension- and fixation-free repair, a specifically designed prosthesis was developed for the surgical treatment of incisional hernias...
November 11, 2016: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/27821941/the-effect-of-abdominal-drawing-in-exercise-and-myofascial-release-on-pain-flexibility-and-balance-of-elderly-females
#18
Seong Hun Yu, Yong Hyeon Sim, Myung Hoon Kim, Ju Hee Bang, Kyung Hyun Son, Jae Woong Kim, Hyun Jin Kim
[Purpose] This study is designed to compare the effects of abdominal drawing-in exercise and myofascial release on pain, flexibility, and balance of elderly females. [Subjects and Methods] Forty elderly females aged 65 or older who had complained of low back pain for three months or longer were selected as the subjects. They were randomly and equally assigned to either an abdominal drawing-in group or a myofascial release group. The subjects conducted exercise three times per week, 40 minutes each time, for eight weeks...
October 2016: Journal of Physical Therapy Science
https://www.readbyqxmd.com/read/27806183/improving-pain-relief-in-elder-patients-i-prep-an-emergency-department-education-and-quality-intervention
#19
Teresita M Hogan, Michael D Howell, John F Cursio, Alexandra Wong, William Dale
OBJECTIVES: To assess the effectiveness of a novel combined education and quality improvement (QI) program for management of pain in older adults in the emergency department (ED). DESIGN: Controlled pre/postintervention examination. SETTING: An academic urban ED seeing 60,000 adult visits annually. PARTICIPANTS: Individuals aged 65 and older experiencing moderate to severe pain. INTERVENTION: Linked standardized education and continuous QI for multidisciplinary staff in an urban, academic ED from January 2012 to January 2014...
December 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27799059/a-postmenopausal-woman-with-sciatica-from-broad-ligament-leiomyoma-a-case-report
#20
Ya-Chu May Tsai
BACKGROUND: Unilateral lower abdominal pain and/or sciatic nerve pain is a common presentation in the elderly population. The prevalence of broad ligament leiomyoma is <1 % with the prevalence declining after the menopause and it is rare for broad ligament leiomyomas to be clinically significant. Thus, we highlight a case of symptomatic broad ligament leiomyoma in a postmenopausal woman whose symptoms improved after definitive treatment. CASE PRESENTATION: A 62-year-old postmenopausal Macedonian woman was referred to our gynecological department with unexplained pain in her left leg and left iliac fossa region on walking...
October 31, 2016: Journal of Medical Case Reports
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