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https://www.readbyqxmd.com/read/28345443/economic-burden-of-irritable-bowel-syndrome-with-diarrhea-retrospective-analysis-of-a-u-s-commercially-insured-population
#1
Jessica L Buono, Kush Mathur, Amelia J Averitt, David A Andrae
BACKGROUND: The economic burden associated with irritable bowel syndrome with diarrhea (IBS-D) is not well understood. OBJECTIVES: To (a) evaluate total annual all-cause, gastrointestinal (GI)-related, and symptom-related (i.e., IBS, diarrhea, abdominal pain) health care resource use and costs among IBS-D patients in a U.S. commercially insured population and (b) estimate incremental all-cause health care costs of IBS-D patients versus matched controls. METHODS: Patients aged ≥ 18 years with 12 months of continuous medical and pharmacy benefit eligibility in 2013 were identified from the Truven Health MarketScan research database...
April 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28345065/diabetic-ketoacidosis-as-the-presenting-manifestation-of-pancreatic-adenocarcinoma-with-cystic-features
#2
Tezcan Kaya, Sumeyye Korkmaz, Erdem Vargol, Alper Karacan, Hakan Cinemre
The common presenting symptoms of pancreatic cancer are abdominal pain, weight loss, and jaundice. Pancreatic adenocarcinoma presenting with diabetic ketoacidosis is a very rare emergent clinical condition. However, pancreatic ductal cystadenocarcinoma presenting with diabetic ketoacidosis was not reported. We describe a 60-year-old man with pancreatic cystadenocarcinoma presenting with diabetic ketoacidosis as the initial manifestation. It must be kept in mind that in diabetic ketoacidosis cases, the precipitating factor may be pancreatic ductal cystadenocarcinoma...
March 2017: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28337350/seat-belt-compression-appendicitis-following-motor-vehicle-collision
#3
Muhammad Faisal Khilji, Qazi Zia Ullah
Appendicitis and trauma both present in emergency department commonly but their presentation together in the same patient is unusual. We present a case of a middle-aged man brought by emergency medical services (EMS) to the emergency department with complaints of abdominal pain after he was involved in motor vehicle collision. He was perfectly fine before the accident. His primary survey was normal. Secondary survey revealed tenderness in right iliac fossa with seat belt mark overlying it. Computerized tomography (CT) of the abdomen and pelvis was performed which showed 8 mm thickening of appendix with minimal adjacent fat stranding...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28332032/qualitative-assessment-of-the-symptoms-and-impact-of-pancreatic-exocrine-insufficiency-pei-to-inform-the-development-of-a-patient-reported-outcome-pro-instrument
#4
Colin D Johnson, Rob Arbuckle, Nicola Bonner, Gary Connett, Enrique Dominguez-Munoz, Philippe Levy, Doris Staab, Nicola Williamson, Markus M Lerch
BACKGROUND: Pancreatic exocrine insufficiency (PEI) affects patients with chronic pancreatitis (CP) and cystic fibrosis (CF) who produce insufficient digestive pancreatic enzymes. Common symptoms include steatorrhoea, diarrhea, and abdominal pain. OBJECTIVE: The objective of the study was to develop and test the content validity of a patient-reported outcome (PRO) instrument assessing PEI symptoms and their impact on health-related quality of life. METHODS: Instrument development was supported by a literature review, expert physician interviews (n = 10: Germany 4, UK 3, France 3), and exploratory, qualitative, concept-elicitation interviews with patients with CF and CP with PEI (n = 61: UK 29, Germany 18, France 14) and expert physicians (n = 10)...
March 22, 2017: Patient
https://www.readbyqxmd.com/read/28331644/term-abdominal-pregnancy-revealed-by-amnioperitoneum-in-rural-area
#5
Henri Donald Mutarambirwa, Bruno Kenfack, Jovanny Tsuala Fouogue
Abdominal pregnancy (AP) accounts for 1% of ectopic implantations. In sub-Saharan Africa, the high prevalence of sexually transmitted infections explains the increasing frequency of this pathology. In Cameroon it rose from 1/10000 deliveries (1995) to 3.3/10000 (2015). Authors herein report a case of a viable abdominal pregnancy discovered at term during emergency laparotomy for suspected uterine rupture. The 24-year-old G2P0 patient was HIV-positive, under antiretrovirals, though AP exceptionally occurs in HIV patients...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28327888/fibromuscular-dysplasia-unusual-cause-of-abdominal-pain
#6
M Alonso-Alcañiz, J M Antolín, J R Rebolledo, C Muñoz-Montano
Spontaneous dissection of the renal artery is a rare phenomenon, and is more common amongst men. It is not a frequent cause of abdominal pain², which is why diagnosis is often late. The case under study is a 45 year old patient that presented sudden pain in the left renal fossa of 12 hours evolution, with no findings from the basic laboratory tests (lab testing, urinary sediment and ultrasound), an abdominal CAT was therefore carried out, which showed areas of renal infarction, as well as an emergency arteriogram, which gave findings of a possible Fibromuscular Dysplasia of the left intrarenal artery as the first diagnostic probability with a partially thrombosed focal dissection...
June 2017: Revista Española de Sanidad Penitenciaria
https://www.readbyqxmd.com/read/28321065/small-bowel-obstruction-caused-by-the-ingestion-of-a-wooden-toothpick-the-ct-findings-and-a-literature-review
#7
Junichi Izumi, Kimihiko Satoh, Wataru Iwasaki, Takaya Miura, Shusei Fujimori
We present a case in which the accidental ingestion of a toothpick caused duodenal perforation and small intestinal obstruction. A 58-year-old man visited our emergency room with acute abdominal pain. Computed tomography (CT) showed obstructive ileus as well as a foreign body penetrating the duodenum, which was identified as a toothpick and removed endoscopically. Unenhanced CT was superior in detecting the object. The patient has been doing well since the operation.
2017: Internal Medicine
https://www.readbyqxmd.com/read/28320545/haloperidol-undermining-gastroparesis-symptoms-hugs-in-the-emergency-department
#8
Rene Ramirez, Philip Stalcup, Brandon Croft, Michael A Darracq
BACKGROUND: Gastroparesis associated nausea, vomiting & abdominal pain (GP N/V/AP) are common presentations to the emergency department (ED). Treatment is often limited to antiemetic, prokinetic, opioid, & nonopioid agents. Haloperidol (HP) has been shown to have analgesic & antiemetic properties. We sought to evaluate HP in the ED as an alternative treatment of GP N/V/AP. METHODS: Using an electronic medical record, 52 patients who presented to the ED w/GP N/V/AP secondary to diabetes mellitus and were treated w/HP were identified...
March 12, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28316930/transudative-pleural-effusion-of-malignant-etiology-rare-but-real
#9
Lindsey Johnson, Hafiz Abdul Moiz Fakih, Salim Daouk, Shaheera Saleem, Ali Ataya
A 62-year-old female presented to the emergency room with one-month history of epigastric abdominal pain, nausea and vomiting. She endorsed progressive dyspnea over two weeks. CT of the abdomen demonstrated bilateral pleural effusions and pancreatic inflammation, so the working diagnosis was pancreatitis. A diagnostic thoracentesis was performed and the pleural fluid analysis was classified as transudate by Light's criteria. Given the atypical features in history and concern for malignancy, fluid was sent for cytological examination and immunohistochemistry which suggested a mucinous malignancy...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28315818/sclerosing-encapsulated-peritonitis-a-devastating-and-infrequent-disease-complicating-kidney-transplantation-case-report-and-literature-review
#10
Liliana Caicedo, Alejandro Delgado, Luis A Caicedo, Juan Carlos Bravo, Laura S Thomas, Martin Rengifo, Jorge I Villegas, Oscar Serrano, Gabriel J Echeverri
INTRODUCTION: Sclerosing Encapsulating Peritonitis (SEP) is a rare condition with an incidence of up to 3% and a mortality of up to 51% among peritoneal dialysis (PD) patients (Brown et al., Korte et al. and Kawanishi et al.). In the last ten years, the incidence of SEP in kidney transplant recipients has increased (Nakamoto, de Sousa et al. and Korte et al.). PRESENTATION OF CASE: A 31-year old male with a 15 years history of PD and later kidney retransplantation was admitted to the emergency service after experiencing several weeks of diffuse abdominal pain which had escalated to include vomiting and diarrhea during the 24h previous to admission...
March 1, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28302233/an-unusual-case-of-caecal-volvulus-due-to-appendicitis-successfully-managed-by-caecopexy
#11
Samiullah Bhatti, Mahmood Ayyaz Khan, Waris Farooka, Usman Ismat Butt, Usman Ali Rehman, Awais Amjad Malik
Caecal volvulus is a rare cause of intestinal obstruction. Caecal volvulus precipitated by acute appendicitis is even rarer. We report an unusual case of caecal volvulus with acute appendicitis as a cause. A 55-year female presented in surgical emergency with 3 days history of abdominal pain, distension and absolute constipation; and 2 days history of vomiting. Her past surgical history was significant for hysterectomy 5 years back. On examination, abdomen was distended and bowel sounds exaggerated. X-ray abdomen erect showed a single large air fluid level in the right hemiabdomen...
March 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28301350/a-phase-ii-study-of-ganetespib-as-second-line-or-third-line-therapy-for-metastatic-pancreatic-cancer
#12
Dana B Cardin, Ramya Thota, Laura W Goff, Jordan D Berlin, Clyde M Jones, Gregory D Ayers, Jennifer G Whisenant, Emily Chan
OBJECTIVES: Heat shock protein 90 regulates multiple signaling proteins involved in key pathways of pancreatic cancer pathogenesis. Ganetespib binds to heat shock protein 90 and interferes with its binding to client proteins thus leading to inactivation and degradation of the signaling proteins that promote cancer progression. This phase II study was designed to evaluate the efficacy of ganetespib in patients with refractory metastatic pancreatic cancer (rMPC). METHODS: Patients with rMPC received 175 mg/m ganetespib intravenously once weekly for 3 weeks in 4-week cycles...
March 15, 2017: American Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28299215/intra-abdominal-actinomycosis-mimicking-malignant-abdominal-disease
#13
Ali Ridha, Njideka Oguejiofor, Sarah Al-Abayechi, Emmanuel Njoku
Abdominal actinomycosis is a rare infectious disease, caused by gram positive anaerobic bacteria, that may appear as an abdominal mass and/or abscess (Wagenlehner et al. 2003). This paper presents an unusual case of a hemodynamically stable 80-year-old man who presented to the emergency department with 4 weeks of worsening abdominal pain and swelling. He also complains of a 20-bound weight loss in 2 months. A large tender palpable mass in the right upper quadrant was noted on physical exam. Laboratory studies showed a normal white blood cell count, slightly decreased hemoglobin and hematocrit, and mildly elevated total bilirubin and alkaline phosphatase...
2017: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/28298776/a-comparative-study-for-post-operative-analgesia-in-the-emergency-laparotomies-thoracic-epidural-ropivacaine-with-nalbuphine-and-ropivacaine-with-butorphanol
#14
Saravana Babu, Bikram Kumar Gupta, Gyanendra Kumar Gautam
BACKGROUND: Adequate postoperative pain therapy for emergency abdominal surgeries is important far beyond the perioperative period because sensitization to painful stimuli can cause postoperative morbidity. A prospective, double-blind, randomized study was carried out to compare the quality of postoperative analgesia and side-effect profile between epidurally administered butorphanol and nalbuphine as an adjuvant to 0.2% ropivacaine. MATERIALS AND METHODS: A total of eighty patients, 43 men and 37 women between the age of 18 and 65 years of American Society of Anesthesiologists (ASA) Class I E and II E, who underwent intestinal perforation repair surgery were randomly allocated into two groups ropivacaine with butorphanol (RB) and ropivacaine with nalbuphine (RN), comprising of 40 patients each...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28296829/ovarian-torsion-in-the-normal-ovary-a-diagnostic-challenge-in-postmenarchal-adolescent-girls-in-the-emergency-department
#15
Erbil Karaman, Burhan Beger, Orkun Çetin, Mehmet Melek, Yasemin Karaman
BACKGROUND Ovarian torsion can be seen in the otherwise-normal ovary and is a challenging issue in the emergency department. The aims were (1) to evaluate and compare the surgically verified ovarian torsion cases in otherwise-normal ovaries and ovaries including a mass or cyst and (2) to investigate whether the normal-appearing ovaries on ultrasound examination affected the diagnosis of ovarian torsion or not. MATERIAL AND METHODS A retrospective cohort study design was used. The medical records of all postmenarchal adolescent girls with surgically verified ovarian torsion treated in a university hospital from 2010 to 2016 were reviewed...
March 15, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28290978/a-30-year-old-female-found-to-have-a-couvelaire-uterus-with-placenta-accreta-during-planned-cesarean-delivery
#16
Omici N Uwagbai, Arthur C Wittich
A case of Couvelaire uterus with placenta accreta found during scheduled repeat low transverse Cesarean section will be discussed within this article. First described in the 1900s, Couvelaire syndrome, also known as uteroplacental apoplexy, is a rare form of nonfatal placenta abruption complication. The case involves a 30-year-old gravida 3 para 2 otherwise healthy female with an uncomplicated pregnancy and two previous cesarean deliveries without complication. She received routine prenatal care. During her pregnancy, she did not experience any symptoms such as vaginal bleeding or abdominal pain...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28290145/successful-surgical-intervention-for-rectal-perforation-due-to-polyarteritis-nodosa-report-of-a-case
#17
Keiji Yoshiya, Yu Imamura, Yu Nakaji, Daisuke Taniguchi, Rinne Takeda, Koji Ando, Yuichiro Nakashima, Motohiro Shimizu, Kippei Ohgaki, Norihiro Furusyo, Takuya Matsumoto, Hiroshi Saeki, Yoshinao Oda, Eiji Oki, Yoshihiko Maehara
BACKGROUND: Polyarteritis nodosa (PAN) is a primary systemic necrotizing vasculitis with diffuse organ involvements, resulting in a high mortality rate due to multiple organ failure. Although the small bowel is the frequently targeted organ of PAN-associated vasculitis, rectal involvement is very rare, and only one case of rectal bleeding has been previously reported. The mortality rate of PAN with gastrointestinal (GI) perforation is reportedly much higher than that of without severe GI involvement...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28286851/a-rare-case-of-gastrointestinal-tract-foreign-body-glassy-stomach
#18
Mohsen Ebrahimi, Jafar Malmir, Azadeh Mahmoudi-Gharaee, Mahdi Foroughian
Ingestion of foreign bodies is common and conservative treatment can eliminated most particlesfrom the gastrointestinal tractunless peritoneal signs appear. A 22-year-old man presented to emergency department who had ingested glass particles of a crushed beveragebottle.Hecomplained ofepigastric and periumbilical pain. Physical examination did not revealany peritoneal signs. Abdominal X-ray showed stomach full of small glass particles. Conservative treatment, without any surgical intervention,resulted insafely eliminating glass particlesin this patient...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28285596/a-small-intestine-volvulus-caused-by-strangulation-of-a-mesenteric-lipoma-a-case-report
#19
Yoshihiko Kakiuchi, Hiroaki Mashima, Naoto Hori, Hirotoshi Takashima
BACKGROUND: An emergency department encounters a variety of cases, including rare cases of the strangulation of a mesenteric lipoma by the greater omentum band. CASE PRESENTATION: A 67-year-old Japanese man presented with nausea, vomiting, and upper abdominal pain. There were no abnormalities detected by routine blood tests other than a slight rise in his white cell count. A contrast-enhanced computed tomography scan of his abdomen revealed a dilated intestine, a small intestine volvulus, and a well-capsulated homogeneous mass...
March 13, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28285209/acute-large-bowel-pseudo-obstruction-due-to-atrophic-visceral-myopathy-a-case-report
#20
Sean M Wrenn, Charles S Parsons, Michelle Yang, Ajai K Malhotra
PURPOSE: Atrophic visceral myopathy is a pathological diagnosis characterized by atrophy of the smooth muscle layers of the viscera with intact ganglia. Rarely, it can present acutely as an intestinal pseudo-obstruction. We describe a rare case report and explore how this diagnosis can be distinguished from other forms of intestinal obstruction. CASE DESCRIPTION: A 60-year-old male with a past medical history of hypothyroidism presented to the emergency department with a two-day history of worsening abdominal distention and pain associated with nausea and vomiting...
February 27, 2017: International Journal of Surgery Case Reports
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