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Abdominal pain adult and paediatric

Vasileios Rafailidis, Claudette Phillips, Gibran Yusuf, Paul Sidhu
Intussusception is often misdiagnosed as a cause of bowel ischemia and obstruction among adults due to its relatively rare presentation outside of the paediatric population. Ultrasound is often the first-line investigation for non-specific abdominal pain and can identify the presence of intussusception. In the adult population, it is essential to evaluate for causes and consequences of intussusception; as a result, computerised tomography is often deemed necessary. However, contrast-enhanced ultrasound allows for evaluation of potential causes and complications, including a neoplastic lead point and ischaemia of the bowel, whilst avoiding ionising radiation or nephrotoxic iodinated contrast...
May 2017: Ultrasound: Journal of the British Medical Ultrasound Society
Li-Hui Deng, Jun-Jie Xiong, Qing Xia
BACKGROUND: Conventional three-incision laparoscopic appendectomy (CTLA) is considered the new golden standard for the treatment of acute appendicitis. However, single-incision laparoscopic appendectomy (SILA) can further reduce the number of abdominal incisions and visible scars. METHODS: Major databases were researched for randomized clinical trials (RCTs) comparing SILA and CTLA for acute appendicitis from January 1983 and to March 2015. The technical feasibility, effectiveness, and safety between SILA and CTLA were compared...
November 15, 2016: Journal of Evidence-based Medicine
S Van Biervliet, C de Clercq, D Declercq, E Van Braeckel, S Van Daele, F De Baets, D De Looze
Cystic fibrosis (CF) is a life-limiting disorder caused by mutations in the cystic fibrosis transmembrane conductance regulator (CFTR). This defective chloride channel, present in different organ systems such as respiratory system, gastrointestinal tract, reproductive system and sweat glands, disturbs the ion and water transport over the membranes leading to the well known CF symptoms. CF has outgrown paediatric care, as half of CF patients are currently adults. The CF gastrointestinal tract has its own particularities...
September 2016: Acta Gastro-enterologica Belgica
Mohamed A Rabie, Charles Godavitarne
INTRODUCTION: The wandering liver is an extremely rare condition in which the liver moves significantly or 'wander' with changes in patient's lie. This is believed to be an acquired condition perhaps precipitated by persistent congenital ventral mesogastrium which acts as an axis or a mesentery for the liver to rotate. The vast majority of reported cases were associated with other chronic abnormalities of the gastrointestinal tract, especially sigmoid volvulus. PATIENTS AND METHODS: We present a case report of an acquired isolated transposition of the liver with a review of the English-language literature of wandering liver in adults and paediatric age group...
January 3, 2017: Acta Chirurgica Belgica
Lorenzo Iughetti, Gianluca Tornese, Maria Elisabeth Street, Flavia Napoli, Claudia Giavoli, Franco Antoniazzi, Stefano Stagi, Caterina Luongo, Sara Azzolini, Letizia Ragusa, Gianni Bona, Clara Zecchino, Tommaso Aversa, Luca Persani, Laura Guazzarotti, Emiliano Zecchi, Alberto Pietropoli, Stefano Zucchini
BACKGROUND: PATRO Children is an ongoing observational, longitudinal, non-interventional, global post-marketing surveillance study, which is investigating the long-term safety and effectiveness of Omnitrope®, a somatropin biosimilar to Genotropin®, in children with growth disturbances. The primary endpoint of PATRO Children is long-term safety and the secondary endpoint is effectiveness, which is assessed by analysing auxological data such as height (HSDS) and height velocity (HVSDS) standard deviation scores...
November 3, 2016: Italian Journal of Pediatrics
Antonio Vitale, Ida Orlando, Giuseppe Lopalco, Giacomo Emmi, Marco Cattalini, Bruno Frediani, Mauro Galeazzi, Florenzo Iannone, Donato Rigante, Luca Cantarini
OBJECTIVES: Periodic fever, aphthous stomatitis, pharyngitis, and cervical adenopathy (PFAPA) syndrome is a non-Mendelian autoinflammatory disorder until now considered to be specifically limited to paediatric age. Recently, an increasing number of reports seems to suggest that PFAPA syndrome, diagnosed by the Marshall criteria revised by Thomas et al., can also affect adults. METHODS: The Marshall/Thomas criteria have been applied to 989 adult patients presenting for recurrent fever episodes: all patients enrolled were reviewed for demographic, clinical, and therapeutic data...
September 2016: Clinical and Experimental Rheumatology
Daniel W Birch, Jerry T Dang, Noah J Switzer, Namdar Manouchehri, Xinzhe Shi, Ghassan Hadi, Shahzeer Karmali
BACKGROUND: Intraoperative hypothermia during both open and laparoscopic abdominal surgery may be associated with adverse events. For laparoscopic abdominal surgery, the use of heated insufflation systems for establishing pneumoperitoneum has been described to prevent hypothermia. Humidification of the insufflated gas is also possible. Past studies on heated insufflation have shown inconclusive results with regards to maintenance of core temperature and reduction of postoperative pain and recovery times...
October 19, 2016: Cochrane Database of Systematic Reviews
Avradip Santra, Falguni Mandi, Abhishek Bandyopadhyay
Genitourinary tuberculosis usually occurs in young adults and the middle-aged and is very uncommon in the paediatric population. It generally presents with haematuria, pyuria, irritative voiding symptoms and flank pain; presentation as a renal mass is highly unusual. We report a two-year-old girl who was referred to the Nil Ratan Sircar Medical College, Kolkata, India, in June 2014 with abdominal pain. Subsequent radiological investigations revealed a left renal hypoechoic mass lesion. A left nephroureterectomy was performed on suspicion of a Wilms' tumour...
February 2016: Sultan Qaboos University Medical Journal
Caroline Maccallum, Sarah Eaton, Daniel Chubb, Stephen Franzi
Torsion of the fatty appendage of the falciform ligament is an extremely rare condition that leads to severe abdominal pain and raised inflammatory markers. It can be recognised on ultrasound or CT scan. The pathophysiology is the same as that involved in the more common torsion and/or infarction of the greater omentum or epiploic appendages. The condition is best managed conservatively with anti-inflammatory analgesia, and the early recognition of this type of torsion may prevent unnecessary operative intervention to look for a source of abdominal pain...
2015: Case Reports in Radiology
Tracy Jackson, Sarah Thomas, Victoria Stabile, Xue Han, Matthew Shotwell, Kelly McQueen
BACKGROUND: The global burden of chronic pain and disability could be related to unmet surgical needs. This systematic review and meta-analysis aims to characterise existing data regarding the prevalence and associations of chronic pain in low-income and middle-income countries; this is essential to allow better assessment of its relationship to pre-operative and post-operative pain as emergency and essential surgical services are expanded. METHODS: According to PRISMA guidelines, we searched PubMed, PsycInfo, and Cochrane registries for articles published before Dec 31, 2013, using the search terms "pain AND (chronic OR persistent) AND (low income countries OR middle income countries OR LMIC OR Africa OR Asia OR Central America OR South America) AND (incidence OR prevalence)...
April 27, 2015: Lancet
Sze Ying Thong, Eliza I-Lin Sin, Diana Xin Hui Chan, Jagdish M Shahani
INTRODUCTION: There is strong evidence that epidural analgesia provides good postoperative pain relief in adults, but its use in infants is less established. In this retrospective study, we present our experience with managing infant epidural analgesia for abdominal surgeries in a tertiary paediatric institution. METHODS: The records of 54 infants who had received a thoracic or lumbar epidural as perioperative analgesia for abdominal surgeries were included. The mean age of the infants was 6...
August 2015: Singapore Medical Journal
José Antonio Rodríguez-Montes, Elena Collantes-Bellido, Eva Marín-Serrano, Isabel Prieto-Nieto, Juan Pedro Pérez-Robledo
BACKGROUND: Lymphangiomas are benign tumours, considered to be congenital malformations of the lymphatic system that predominately affect children, with only a few cases reported in adults. The most common sites of these lesions are the neck (75%) and axillary region (20%), but rarely found in the spleen. OBJECTIVE: A description is presented of 3 cases of incidentally detected splenic lymphangioma, one in a child and in 2 adults, respectively, as well as a literature review...
March 2016: Cirugia y Cirujanos
Joachim Krylborn, Marie E Anell-Olofsson, Catarina Bitkover, Stefan Lundeberg, Marco Bartocci, Carl-Olav Stiller, Bjorn A Larsson
BACKGROUND: Epidurals may be challenging in neonatal patients due to technical difficulties relating to insertion and the risk of local anaesthesia toxicity. The use of wound catheters with an infusion of local anaesthetic has been shown to be well tolerated in adults and older children. There are few data concerning wound catheter techniques in neonatal patients. OBJECTIVES: The primary aim of this study was to analyse plasma levels of levobupivacaine associated with continuous wound infiltration via a catheter following neonatal surgical procedures...
December 2015: European Journal of Anaesthesiology
Michael Collin, Adrian Charles, Andrew Barker, Japinder Khosa, Naeem Samnakay
INTRODUCTION: Inflammatory myofibroblastic tumours of the bladder (IMTB) are rare, and feature a benign and reactive proliferation of myofibroblasts. 25% of the reported IMTB cases in the literature occur in children. The present study presents a review of IMTB in children. DISCUSSION: The data from 42 reported cases of paediatric IMTB in the world literature are summarised, including two recent cases from the present centre. Paediatric IMTB equally affects males and females...
October 2015: Journal of Pediatric Urology
Luckshika Udeshani Amarakoon, Baj Gamage Anushka Rathnamali, Jasin Arachchige Saman Bingumal Jayasundara, Ajith de Silva
Midgut malrotation includes a range of developmental abnormalities that occur during fetal intestinal rotation. Manifestations of intestinal malrotation are generally seen in the paediatric population and are uncommon in adults. Symptomatic patients may present with either acute abdominal pain due to midgut volvulus, or chronic abdominal pain due to proximal midgut partial obstruction in the presence of congenital bands. A limited number of paediatric cases of duodenal occlusion due to duodenal malrotation has been previously reported in the medical literature...
December 2014: Singapore Medical Journal
Poul Edling, Anders Tøttrup
Intestinal malrotation occurs during foetal development when the normal rotation and fixation of the midgut fails to take place. This condition may lead to volvulus and duodenal obstruction. It is almost exclusively a paediatric diagnosis, but it can become symptomatic much later in life. A 49-year-old woman, who had been suffering from intermittent abdominal pain for most of her adult life, was admitted to the hospital with severe abdominal pain. A computed tomography showed a displaced caecum and mesenteric whirlpool sign...
December 15, 2014: Ugeskrift for Laeger
Khalid N Shehzad, Sherif Monib, Omer F Ahmad, Amjid A Riaz
Intussusception in adults is a rare condition, in contrast to paediatric intussusception where the majority of cases are idiopathic, ∼90% of adult cases have identifiable aetiology. The clinical presentation is often non-specific abdominal pain. We report the case of a 49-year-old gentleman who presented to our emergency department with a 10-day history of colicky abdominal pain. Computed tomography imaging revealed a lipomatous mass lesion in the transverse colon leading to intussusception. An extended right hemicolectomy was performed with a good result...
2013: Journal of Surgical Case Reports
Peter A Ongom, Christopher K Opio, Stephen C Kijjambu
BACKGROUND: Adult intussusception is a rare clinical condition worldwide. It contributes to less than 5% of all cases of intussusception. Few studies have been conducted in low-income countries compared to high-income countries; particularly Sub-Saharan Africa. Based on anecdotal evidence, the authors hypothesized that the condition is not as rare in a Sub-Saharan setting in comparison with western countries. We set out to conduct the first review study of adult intussusception in Uganda...
2014: BMC Gastroenterology
Sonali Patel, Natasha Eagles, Peter Thomas
Abdominal pain secondary to intussusception is a common presentation in the paediatric population but rare in adults. Diagnosis is often difficult due to non-specific signs and symptoms. Adult intussusception presents more insidiously with intermittent abdominal pain and signs and symptoms of an acute abdomen are rare. In children, the aetiological factor is usually idiopathic, whereas intussusception in adults is more commonly due to an underlying pathology giving rise to a lead point. Consequently the treatment of choice is different-while it is supportive in children, surgical management is typically indicated in adults...
May 28, 2014: BMJ Case Reports
Gulsum Emel Pamuk, Umit Tapan, Sema Aksoy, Hasan Umit
Pancreatic involvement in acute lymphoblastic leukaemia (ALL) may go unrecognised. There are only a few paediatric cases; nevertheless, presentation with pancreatic involvement in an adult patient with ALL has been reported rarely. Our 52-year-old male patient came to us with abdominal pain, nausea and vomiting; he had pancreatic enlargement on CT. He was diagnosed with common B-cell ALL with pancreatic involvement. The patient obtained haematological remission and the pancreatic enlargement regressed after chemotherapy, but later he had central nervous system and liver relapses...
May 22, 2014: BMJ Case Reports
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