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Elderly abdominal pain

N Swathi, N Ashwini, Mukesh I Shukla
INTRODUCTION: To compare the efficacy of combination of epidural local anesthetic with tramadol and butorphanol in major abdominal surgeries. AIMS: To evaluate duration of analgesia, analgesic efficacy, and safety profile of two groups of drugs-epidural butorphanol with bupivacaine and epidural tramadol with bupivacaine. MATERIALS AND METHODS: A prospective, randomized controlled, double-blinded study was undertaken in 50 patients scheduled for major abdominal surgeries...
September 2016: Anesthesia, Essays and Researches
Burke A Cunha, John Gian
BACKGROUND: Hospitalized adults with fever and "pneumonia" can be a difficult diagnostic challenge particularly when the clinical findings may be due to different infectious diseases. METHODS: We recently had an elderly female who presented with fever, fatigue and dry cough with elevated serum transaminases and lung infiltrates. The diagnosis of Epstein-Barr virus (EBV) infectious mononucleosis (IM) was made based on a positive Monospot test, elevated EBV VCA IgM titer, and highly elevated EBV viral load...
October 3, 2016: Heart & Lung: the Journal of Critical Care
Mariateresa Mirarchi, Emilio De Raffele, Francesco Bacci, Dajana Cuicchi, Ferdinando Lecce, Bruno Cola
: Solitary extramedullary plasmacitomas (SEMP) of the liver are very rare. We report the case of an elderly woman with a huge symptomatic SEMP of the liver mimicking hepatocellular carcinoma (HCC). The patient was a 89-year-old woman who presented with severe abdominal pain and a huge solid mass in the right hypochondrium. The laboratory data on admission revealed normal liver function tests. A multiphasic computed tomography (CT) showed a huge solid mass of the left hemiliver, hypoattenuating on noncontrast images, dishomogeneously hyperenhancing in the late arterial phase, with washout in the portal venous and equilibrium phases...
2016: Annali Italiani di Chirurgia
Xiaoming Yuan, Guangrong Zhou, Yan He, Aiwen Feng
BACKGROUND: Epithelial dysplasia and adenomatous polyps of colorectum are precancerous lesions. Surgical removal is still one of the important treatment approaches for colorectal polyps. CASE PRESENTATION: A male patient over 78 years was admitted due to bloody stool and abdominal pain. Colonoscopic biopsy showed a high-grade epithelial dysplasia in an adenomatous polyp of sigmoid colon. Anemia, COPD, ischemic heart disease (IHD), arrhythmias, and hypoproteinemia were comorbidities...
September 26, 2016: World Journal of Surgical Oncology
Daniel Frank, Stephen Harding
No abstract text is available yet for this article.
October 2016: Annals of Emergency Medicine
Mirella Fraquelli, Giovanni Casazza, Dario Conte, Agostino Colli
BACKGROUND: Cholelithiasis refers to the presence of gallstones, which are concretions that form in the biliary tract, usually in the gallbladder. Cholelithiasis is one of the most common surgical problems worldwide and is particularly prevalent in most Western countries.Biliary colic is the term used for gallbladder pain experienced by a person with gallstones and without overt infection around the gallbladder. It is the most common manifestation of cholelithiasis, observed in over one-third of people with gallstones over the course of 10 or more years...
September 9, 2016: Cochrane Database of Systematic Reviews
Ding-Kuo Chien, Ming-Yuan Huang, Chien-Hsuan Huang, Shou-Chuan Shih, Wen-Han Chang
OBJECTIVE: Acute myocardial infarction (AMI) is a medical emergency; a missed or delayed diagnosis of this disease may contribute to a poor outcome and even death. Several studies have found elderly patients with AMI have atypical presentations for diagnosis, therefore we undertook this study to determine the risks among the elderly population, especially in female patients. MATERIALS AND METHODS: In this one-year retrospective study, we reviewed the cases of AMI patients who had visited the emergency department at Mackay Memorial Hospital, Taiwan, and who had either been discharged or had died following a diagnosis of AMI (ICD code 410)...
August 2016: Taiwanese Journal of Obstetrics & Gynecology
Christopher Fenelon, Michael R Boland, Brian Kenny, Peter Faul, Shona Tormey
Colonic duplication cysts are rare congenital malformations that predominantly present before the age of 2 years. We report the case of a 74-year-old lady who presented with sudden onset abdominal pain. A computed tomography scan noted a calcified structure adjacent to abnormal loops of bowel. Intraoperative findings revealed an ischaemic loop of small bowel wrapped around a mass in the mesentery adjacent to the sigmoid colon. Final histology revealed a colonic duplication cyst. Colonic duplication cysts are rare entities that most commonly cause obstruction or perforation...
2016: Journal of Surgical Case Reports
Rocío Ruiz Guardiola, Juana Luisa Huertas Riquelme, Julio Sánchez Corral, Beatriz Garrido Benito
No abstract text is available yet for this article.
August 23, 2016: Cirugía Española
Young-Hsiang Lin, Shih-Kai Hung, Wen-Yen Chiou, Moon-Sing Lee, Bing-Jie Shen, Liang-Cheng Chen, Dai-Wei Liu, Wei-Ta Tsai, Po-Hao Lin, Yi-Ting Shih, Feng-Chun Hsu, Shiang-Jiun Tsai, Michael W Y Chan, Hon-Yi Lin
BACKGROUND: Clinically, elderly patients with unresectable bulky hepatocellular carcinoma (HCC) are difficult to manage, especially in those with co-infections of hepatitis B and C virus. Herein, we reported such a case treated with radiotherapy (RT) by using combined simultaneously integrated inner-escalated boost and volumetric-modulated arc radiotherapy (SIEB-VMAT). After RT, significant symptoms alleviation and durable tumor control were observed. CASE SUMMARY: At presentation, an 85-year-old male patient complained abdominal distention/pain, poor appetite, and swelling over bilateral lower limbs for 1 month...
August 2016: Medicine (Baltimore)
Samuel Fernandes, Ana Rita Gonçalves, Luís Araújo Correia
A 73-year-old man was admitted to our clinic with sudden left quadrant abdominal pain and hematochezia. There was no history of trauma. He denied other symptoms or taking off-the-counter medication. His medical history was relevant for ischemic and aortic-mitral valve disease with prosthetic valves for which he was medicated with aspirin and warfarin. On physical examination the patient presented normal vital signs with tenderness on palpation of the left side of the abdomen. Laboratory tests revealed moderate anemia (10...
August 2016: Revista Española de Enfermedades Digestivas
Cheng-Hsien Hsieh, Ming-Yi Hsu, Cheng-Chung Liu
No abstract text is available yet for this article.
September 2016: Emergency Medicine Journal: EMJ
Tracy Jackson, Sarah Thomas, Victoria Stabile, Matthew Shotwell, Xue Han, Kelly McQueen
BACKGROUND: The global burden of chronic pain is projected to be large and growing, in concert with the burden of noncommunicable diseases. This is the first systematic review and meta-analysis of the prevalence of chronic pain without clear etiology in general, elderly, and working populations of low- and middle-income countries (LMICs). METHODS: We collected and reported data using Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines, excluding acute pain or pain associated with a concurrent medical condition...
September 2016: Anesthesia and Analgesia
Kittichet Phiphatpatthamaamphan, RathaKorn Vilaichone
BACKGROUND: Colorectal cancer is one of the major health problems worldwide. However, limited studies have been reported from ASEAN countries. This study was conducted to evaluate clinical characteristics and survival of colorectal cancer cases aged <65 years and ≥65 years in the central region of Thailand. MATERIALS AND METHODS: Clinical information, histological features, endoscopic findings and treatment outcome were collected and reviewed from Thammasat University Hospital, Pathumthani, Thailand between November 2011 and October 2015...
2016: Asian Pacific Journal of Cancer Prevention: APJCP
Astha Singhal, Yu-Yu Tien, Renee Y Hsia
Prescription drug abuse is a growing problem nationally. In an effort to curb this problem, emergency physicians might rely on subjective cues such as race-ethnicity, often unknowingly, when prescribing opioids for pain-related complaints, especially for conditions that are often associated with drug-seeking behavior. Previous studies that examined racial-ethnic disparities in opioid dispensing at emergency departments (EDs) did not differentiate between prescriptions at discharge and drug administration in the ED...
2016: PloS One
Georgios Sahsamanis, Konstantinos Maltezos, Panagiotis Dimas, Alexandros Tassos, Christos Mouchasiris
INTRODUCTION: Gallstone bowel obstruction is a rare form of mechanical ileus usually presenting in elderly patients, and is associated with chronic or acute cholecystitis episodes. CASE PRESENTATION: We present the case of an 80year old female with abdominal pain, inability to defecate and recurrent episodes of diarrhea for the past 8 months. CT examination uncovered a cholecystoduodenal fistula along with gas in the gall bladder and the presence of a ≥2cm gallstone inside the small bowel lumen causing obstruction...
2016: International Journal of Surgery Case Reports
Masaaki Shida, Yoshihiko Kitajima, Masayuki Tanaka, Hiroharu Tsuji
INTRODUCTION: Abdominal compartment syndrome or intra-abdominal hypertension may occur after intra-abdominal events, but their etiology and clinical signs remain unclear. We report a case of abdominal compartment syndrome in an elderly patient without other risk factors. PRESENTATION OF CASE: An 86-year-old man had been admitted to our hospital several times for a dilated sigmoid colon with elongation, and had complained about abdominal pain and abdominal fullness...
2016: International Journal of Surgery Case Reports
Phillip D Magidson, Joseph P Martinez
With an aging population, emergency department clinicians can expect an increase in geriatric patients presenting with abdominal pain. Compared with younger patients, this patient population is less likely to present with classic symptoms, physical examination findings, and laboratory values of abdominal disease. However, the morbidity and mortality associated with elderly patients presenting with abdominal pathologic conditions are significant. For this reason, the clinician must be familiar with some subtle and not so subtle differences when caring for the geriatric patient with abdominal pain to ensure timely diagnosis and appropriate treatment...
August 2016: Emergency Medicine Clinics of North America
Toshiyuki Adachi, Masashi Haraguchi, Junji Irie, Tomoko Yoshimoto, Ryohei Uehara, Shinichiro Ito, Hirotaka Tokai, Kazumasa Noda, Nobuhiro Tada, Masataka Hirabaru, Keiji Inoue, Shigeki Minami, Susumu Eguchi
Gallbladder small cell carcinoma (SCC) comprises only 0.5 % of all gallbladder cancer and consists of aggressive tumors with poor survival outcomes against current treatments. These tumors are most common in elderly females, particularly those with cholecystolithiasis. We report the case of a 79-year-old woman with gallbladder small cell carcinoma. The patient had intermittent right upper quadrant abdominal pain and was admitted to our hospital due to suspected acute cholecystitis. She regularly received medical treatment for diabetes, hypertension, and dyslipidemia...
December 2016: Surgical Case Reports
Kathryn M Adams, Nicole M Roe
Intussusception is an extremely rare diagnosis in adults, with an etiologic process identified in the majority of cases. The authors describe an unusual case of mucosa-associated lymphoid tissue (MALT) lymphoma as the underlying cause of ileocecal intussusception in an elderly woman. The patient presented with complaints of abdominal pain of variable intensity that had increased in severity over the past several months. A contrast-enhanced computed tomographic scan revealed evidence of ileocecal intussusception, and a subsequent exploratory laparotomy revealed high-grade bowel obstruction...
August 1, 2016: Journal of the American Osteopathic Association
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