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At least 19 recordsLinked to original sources
PubMed1996

Evaluation of automatic knowledge acquisition techniques in the diagnosis of acute abdominal pain. Acute Abdominal Pain Study Group.

Clinical diagnosis in acute abdominal pain is still a major problem. Computer-aided diagnosis offers some help; however, existing systems still produce high error rates. We therefore tested machine learning techniques in order to improve standard statistical systems. The investigation was based on a prospective clinical database with 1254 cases, 46 diagnostic parameters and 15 diagnoses. Independence Bayes and the automatic rule induction techniques ID3, NewId, PRISM, CN2, C4.5 and ITRULE were trained with 839 cases and separately tested on 415 cases. No major differences in overall accuracy were observed (43-48%), except for NewId, which was below the average. Between the different techniques some similarities were found, but also considerable differences with respect to specific diagnoses. Machine learning techniques did not improve the results of the standard model Independence Bayes. Problem dimensionality, sample size and model complexity are major factors influencing diagnostic accuracy in computer-aided diagnosis of acute abdominal pain.

Abdominal Pain↗
PubMed1985

Upper gastrointestinal endoscopy in children with abdominal pain.

Abdominal pain is a common gastrointestinal symptom in children. The purpose of this paper is to determine the upper gastrointestinal mucosal pathology in a group of children with abdominal pain. 48 consecutive children referred to the authors with the problem of abdominal pain were studied. These were divided into 2 groups. Those with only one episode of pain and lasting for less than 2 weeks were considered to have acute abdominal pain. Those with repeated episodes of pain and lasting for more than 2 weeks were considered to have recurrent abdominal pain. Careful clinical examination was done to exclude an acute surgical abdomen. Other common causes of abdominal pain in our population such as urinary tract infection, lactose intolerance, hepatitis and choledochal cyst were excluded by clinical examinations and laboratory investigations. Upper gastrointestinal endoscopy was done by one of the authors. Five out of the 16 children with acute abdominal pain had macroscopic features of acute gastritis and another 2 had duodenitis. In the other 32 children with recurrent abdominal pain, 5 had duodenal ulcers and 3 had reflux oesophagitis. It was concluded that upper gastrointestinal endoscopy was a useful means of identifying the upper gastrointestinal pathology in children with abdominal pain. 43% and 25% of the children with acute and recurrent abdominal pain respectively had a cause identified by gastroscopy.

Abdomen↗
PubMed2003

Imaging and the child with abdominal pain.

Abdominal pain is a common presenting symptom in children. A substantial percent of unscheduled paediatric office visits and paediatric emergency room visits are due to abdominal pain. Children may present with an acute episode of pain or with chronic, recurrent pain. Only a small fraction of children presenting with abdominal pain will prove to have an organic cause necessitating interventional management. In this essay, a discussion of abdominal pain is presented, with particular emphasis on the role of radiologic imaging tests to investigate potential causes of abdominal pain. The more common and clinically significant causes of abdominal pain in a child will be discussed in greater detail.

Abdominal Pain↗
PubMed1999

An unusual cause of recurrent abdominal pain.

Abdominal pain is a common complaint with diverse etiologies. We describe an unusual case of recurrent abdominal pain in an adult due to lead poisoning, a condition usually associated with childhood. A previously healthy 42-yr-old man presented with 2 days of severe crampy abdominal pain and a 1-month history of constipation. Physical examination was remarkable for diffuse abdominal pain but peritoneal signs were not present. Blood tests were remarkable for hematocrit of 33 and mean cell volume of 78, with ovalocytes and basophilic stippling on blood smear. Abdominal x-ray showed stool throughout the colon and a nonspecific bowel gas pattern. The patient was treated with intravenous fluids and enemas, and his symptoms resolved within 2 days. Repeat history taking revealed he had been stripping paint from an old Victorian house in the preceding few months. He was discharged after a blood lead level was obtained. Before his clinic appointment he was readmitted 2 days later with recurrent abdominal pain. His blood lead level was elevated at 110 microg/dl (toxic range). After consultation with the Occupational Health and Safety Administration and local poison control service, he was treated with intravenous calcium edetate disodium and intramuscular dimercaprol. He was asymptomatic at discharge, with a level of 56 microg/dl. Two weeks later, a repeat level was elevated at 72 microg/dl, for which he received a 3-wk course of oral dimercaptosuccimer. Subsequent levels were unremarkable, and the patient remains asymptomatic. Abdominal pain secondary to lead poisoning in adults is uncommon. This case highlights the importance of taking a detailed occupational history and appropriately using "routine" blood tests to diagnose a rare condition that presented with a common complaint.

Abdominal Pain↗
PubMedDate not supplied

[Acute lead intoxication--a rare cause of abdominal pain].

Abdominal pain is a common symptom of various diseases and conditions of different aetiology. The aim of the interpretation of abdominal pain is to reach an early and accurate diagnosis, thereby enabling appropriate treatment. Acute abdominal pain may be the result of a number of abdominal, as well as extra-abdominal causes, lead poisoning being one such extra-abdominal cause. Here, we report the case of a 73-year-old male patient, admitted for clinical investigation of a suspected tumour of the colon, due to the presence of acute convulsive abdominal pain, without propagation, constipation, and anaemia. A history provided by the patient's family indicated his exposure to lead. The absence of any abdominal pathology, increased levels of lead in the blood (5.249 micromol/l), the presence of basophilically punctuated red blood cells, as well as a ring of sideroblasts, all indicated that the patient's symptoms (abdominal pain, constipation, and anaemia) were the result of acute lead intoxication. The patient's case history, including lead exposure, the absence of pathological findings via endoscopic and x-ray examination, laboratory findings (normocytic anaemia, an increased serum lead concentration, basophilically punctuated red blood cells, and the presence of an abundant ring of sideroblasts), all indicated that his symptoms were the result of lead intoxication. After six months of chelation therapy (EDTA), his symptoms completely disappeared, and his laboratory findings returned to normal. This presentation aims to underscore the importance of meticulous history taking, as well as of the selection of suitable laboratory and other auxiliary diagnostic methods in the correct diagnosis of this rare condition.

Abdominal Pain↗
PubMed2003

Pearls and pitfalls in the emergency department evaluation of abdominal pain.

Abdominal pain is a common complaint in the emergency department (ED), comprising approximately 5% of total visits. Although not typically serious, abdominal pain often presents many difficult situations for the clinician. Women of reproductive age and elderly individuals represent some of the most challenging patients to evaluate. Although there are general diagnostic and clinical principles that apply to the evaluation of all patients, these two groups deserve extra attention because of the broad differential diagnosis and potential for serious complications. This article outlines the epidemiology of abdominal pain in patients who present to the ED, and provides guidelines pertinent to the evaluation of all patients. In addition, the article discusses the approach to abdominal pain of pelvic origin in women of reproductive age and abdominal pain in elderly individuals.

Abdominal Pain↗
PubMed1994

Abdominal pain.

Abdominal pain remains a common complaint in children and adolescents and accounts for a frequent number of visits to pediatricians as well as gastroenterologists. A thorough understanding of the neuroanatomy and neurophysiology of the abdomen and its contents is immensely important in understanding the origins of abdominal pain and formulating a limited differential diagnosis for the patient presenting with abdominal pain. With this as fundamental background, and the important clues provided by a thorough history and physical examination, a rapid and accurate diagnosis for the pediatric patient presenting with either acute, subacute, or chronic abdominal pain can be in most instances reasonably ascertained. Subsequently, specific studies for confirmation can then be performed and appropriate treatment implemented. The tremendous advancement in the field of gastroenterology provided by the continued development of endoscopic procedures has allowed for precise identification of many GI disorders. Endoscopy in concert with radiology procedures can be used effectively now to adequately establish a diagnosis in almost all patients presenting with abdominal pain.

Abdomen, Acute↗
PubMedDate not supplied

[Clinical characteristics and follow-up of patients with AIDS and acute abdominal pain].

Abdominal symptoms frequently affect patients with AIDS. Acute abdominal pain is a diagnostic challenge that may require elective or urgent surgical treatment, although information about the latter is scarce. In this study we analyzed the clinical findings and follow-up of acute abdominal pain complicating patients with AIDS. In a two-year period, we collected several variables from patients with AIDS and acute abdominal pain: demographic, laboratory, clinical symptoms, initial diagnosis, surgical findings, post-surgical and histopathological diagnosis and post-surgical complications. From 232 hospitalized patients, 34 had acute abdominal pain: 32 male and 2 women (median age = 32 years; range 26 to 58 years). Twenty-two patients required surgical treatment. Eight patients had a post-surgical complication; in five of them, six surgical re-interventions were performed. Three deaths occurred in the 30-day period after surgery. Survival for patients conservatively treated was 4 months (1 to 17 months), vs. 6.5 months (1 to 20 months) in the surgically treated group. Physicians should be aware about the several diagnostic possibilities of acute abdominal pain complicating patients with AIDS. Delay of surgery in these patients may be lethal. Surgery has an important role in the integral treatment of patients with AIDS.

Abdominal Pain↗
PubMed1999

Prevalence of cytomegalovirus in the gastrointestinal tract of renal transplant recipients with persistent abdominal pain.

Abdominal pain occurs frequently in renal transplant recipients receiving mycophenolate mofetil (MMF) therapy. The cause of this abdominal pain has not been fully elucidated, but may involve local irritation, as well as inhibition of rapidly dividing cells of the gastrointestinal (GI) tract. This milieu of inflammation and added immunosuppression is conducive to activation of cytomegalovirus (CMV). We therefore sought to find the prevalence of active CMV in patients presenting with abdominal pain on maintenance MMF therapy. All patients receiving a renal transplant at our center from March 1, 1997, to September 1, 1997, were studied. Any patient presenting with midepigastric pain for greater than 3 days underwent esophagogastroduodenoscopy (EGD) with biopsy. CMV was diagnosed by the presence of inclusion bodies and immunohistochemical studies. Ten patients presented with persistent midepigastric pain; nine of these patients had evidence of GI CMV. Patients who were CMV negative and received an allograft from CMV-positive donors and those with leukopenia were at significantly increased risk for the development of abdominal pain. In our study population, the majority of patients on maintenance MMF therapy who presented with persistent midepigastric pain had evidence of active CMV infection in the upper gastrointestinal tract.

Abdominal Pain↗
PubMedDate not supplied

Acute abdominal pain.

Abdominal pain is among the most frequent ailments reported in the office setting and can account for up to 40% of ailments in the ambulatory practice. Also, it is in the top three symptoms of patients presenting to emergency departments (ED) and accounts for 5-10% of all ED primary presenting ailments. There are several common sources for acute abdominal pain and many for subacute and chronic abdominal pain. This article explores the history-taking, initial evaluation, and examination of the patient presenting with acute abdominal pain. The goal of this article is to help differentiate one source of pain from another. Discussion of acute cholecystitis, pancreatitis, appendicitis, ectopic pregnancy, diverticulitis, gastritis, and gastroenteritis are undertaken. Additionally, there is discussion of common laboratory studies, diagnostic studies, and treatment of the patient with the above entities.

Abdomen, Acute↗
PubMed2006

Pain-related impairment and health care utilization in children and adolescents: a comparison of orofacial pain with abdominal pain, back pain, and headache.

OBJECTIVE: The purpose was to compare orofacial (temporomandibular) pain with other pain complaints regarding impairment and health care utilization in a sample of 1,011 children and adolescents from a metropolitan area in Germany. METHOD AND MATERIALS: Individuals aged 10 to 18 years were sampled in schools using a 2-stage cluster technique. Orofacial pain in the previous month was assessed according to the Research Diagnostic Criteria for Temporomandibular Disorders. Additionally, participants were questioned about headache, back pain, abdominal pain, pain-related impairment, and health care utilization (visits to doctors, analgesic consumption) in the previous month. RESULTS: Headache was reported by 50% (95% CI: 45% to 56%) of participants, stomach pain by 36% (95% CI: 32% to 41%), back pain by 31% (95% CI: 25% to 36%), and orofacial pain by 15% (95% CI: 12% to 18%). Girls were more affected than boys. The range of "severe" and "very severe" impairment lay between 8% (orofacial pain) and 22% (headache). The range of treatment demand was between 10% and 17% (orofacial pain: 15%), and the range for analgesic consumption between 18% and 24% (orofacial pain: 22%). The more pain experienced, the more impairment, doctor consultations, and analgesic consumption were reported (Chi2test: P < 0.05). Risk of orofacial pain was 60% higher for subjects with head, back, and/or abdominal pain (odds ratio: 1.6; 95% CI: 1.3 to 1.9). CONCLUSION: In children and adolescents, orofacial pain occurs about half as often as other pain complaints. However, relative to their prevalence the different pain complaints are similar regarding impairment and health care utilization.

Abdominal Pain↗
PubMedDate not supplied

Assessment of the patient with acute abdominal pain.

Abdominal pain has many causes, from simple to complex presentations. Patients with abdominal pain may have a number of physiological and psychological needs. Nurses have a key role to play in patient assessment, history talking and management.

Abdominal Pain↗
PubMedDate not supplied

Assessment of the patient with acute abdominal pain.

Abdominal pain has many causes, from simple to complex presentations. Patients with abdominal pain may have a number of physiological and psychological needs. Nurses have a key role to play in patient assessment, history taking and management.

Abdomen↗