جستجوی مقالات مرتبط با کلیدواژه « abdominal pain » در نشریات گروه « پزشکی »

Splenic infarcts are uncommon and may not be readily considered in the emergency department, as the clinical presentation often mimics acute abdominal pain. While atherosclerotic damage commonly occurs at the abdominal aorta and its branching parts**, it can also affect the splenic artery, potentially leading to splenic infarction. Although it is widely acknowledged that the abdominal aorta and its branches are the most common sites for atherosclerotic damage, atherosclerosis of the splenic artery can also be an etiological factor for splenic infarction, leading to impaired blood flow in the spleen. Splenic infarction represents a clinical scenario that is not frequently encountered, and its presentation can resemble other causes of acute abdominal pain. This case report describes a patient who presented to the emergency department (ED) with abdominal pain and was subsequently diagnosed with splenic infarction secondary to atherosclerosis of the splenic artery.

Functional abdominal pain (FAP) is one of the most common gastrointestinal disorders affecting children. Evidence suggests the primary role of physiological factors in the development of FAP in children. Obsessive-compulsive disorder (OCD) creates excessive worrying, distress, mental preoccupation, and low self-esteem. The purpose of this study was to examine whether parental OCD is associated with the prevalence of FAP among children.

The purpose of this study was to examine whether parental OCD is associated with the prevalence of FAP among children.

This case-control study examined 200 parents of children and adolescents (4-16 years old) with and without FAP. The New Rome criteria (Rome IV) were used to diagnose FAPs. This study used the obsessive-compulsive inventory-revised (OCI-R) to assess different domains of OCD symptoms in parents. The other required information, such as age, demographic information, and socioeconomic status (SES), was collected through self-administered questionnaires.

The study included 88 parents of children with FAP as the case group and 100 parents of children without FAP as the control group. Comparing cases with controls, significant differences were observed in age, occupation and number of siblings. The mean case and control OCR-I scores were 28.81±10.57 and 20.83±13.16, respectively. Furthermore, the case group scored significantly higher in washing, obsessing, neutralizing, ordering, and checking subscale scores than controls.

The results of this study indicate that parental OCD is associated with the prevalence of FAP in children. Parents who suffer from OCD are more likely to have children with FAP. Parental OCD symptoms may influence the progression and development of FAP. However, more studies are warranted to confirm our results.

  Irritable bowel syndrome (IBS) is a functional bowel disorder characterized by changes in bowel movements and abdominal pain in the absence of structural disorders. Although effective treatment for irritable bowel syndrome is not yet available. One of the treatments is the low-dose antidepressants, depending on the type and severity of the disease. This study was performed to compare the effect of selective serotonin-norepinephrine reuptake inhibitors including duloxetine and imipramine from a tricyclic antidepressant.

forty-eight definitively diagnosed IBS patients (based on Rome III criteria) were examined in 2 groups of men and women. Patients in the control group were treated with Dicyclomine and Imipramine while the case group received dicyclomine and duloxetine. The outcomes were measured before and 3 months after treatment to determine and compare the improvement in responses (mainly diarrhea).

Duloxetine could significantly improve the symptoms such as abdominal pain in females (P-value: 0.01) and males (P-value: 0.001), bloating in females (P-value: 0.004) and incomplete defecation in females (P-value: 0.001) and in males (P-value: 0.007). The side effects of this drug were, however, higher than Imipramine. The introduction of more appropriate treatment requires further studies on a larger sample size to assess the symptoms and the side effects.

 Based on the effect of duloxetine on this clinical results, it is recommended as an effective treatment in controlling of abdominal pain, bloating, and incomplete defecation.

Studies have shown that Celiac Disease (CD) can present with patchy mucosal lesions. The aim of this study is to investigate the utility of duodenal bulb biopsy in the diagnosis of CD in some Iranian children. Moreover, we compare disease characteristics in children with CD consistent histology limited to the duodenal bulb (D1) with those of children with CD-related histology in the second part of duodenum (D2) with or without histology changes in D1.

This is a cross sectional study on anti-tissue transglutaminase antibody (anti TTG Ab) positive children in Mashhad between 2019 and 2021. Intestinal biopsies from D1 and D2 were done. Diagnosis of CD was defined by the Marsh classification above 1. Patients of 2 groups compared in terms of clinical and laboratory parameters.

from 81 serology positive patients, 70 patients were diagnosed with CD, based on Marsh classification. Among them, 6 patients (8.6%) had exclusive involvement of D1, and 64 cases (91%) had involvement of D2 with or without D1. The two groups did not have a statistically significant difference in terms of clinical presentation, serological and histopathological values.

Taking D1 biopsies can improve case finding of CD in the pediatric population.

Ectopic pregnancy (EP) is the leading cause of early pregnancy accounting for 10-15% of pregnancy-related deaths. It is lifethreatening condition where the majority of them present late. This study aims to evaluate the incidence, risk factors, clinical features, diagnosis, and management of EP in the tertiary care center.

This study conducted a retrospective analysis of electronic medical records from June 2015 to June 2020, focusing on participants in the age group of 18 to 45 years, to examine the occurrence of EP. The data were analysed with simple descriptive statistics and presented in frequency tables and charts of age group, parity, anemia grades, risk factors and presenting symptoms.

The incidence of EP in the current study was 0.38%. In the present study, 73.8% of women were of 20–30-year-old. In this study, 54.1% of women had a history of pelvic inflammatory disease (PID). Prior EP was seen in 19.7 % of cases. 16.4% of participants had a prior history of tubectomy and 19.7% had a previous history of infertility treatment, and 21.3% had a previous history of lower segment caesarean section (LSCS). In the present study, 65.5% of women presented with amenorrhea of 4-8 week, and 95% had abdominal pain. In the present study, common site was the right fallopian tube in 73.9% of cases. In this study, all cases need surgical management most common procedure carried out was salpingectomy. intensive care unit (ICU) admission was needed in 26.2% of cases, and no mortality was seen in our study.

EP is a serious and potentially life-threatening condition. Early diagnosis and prompt management are crucial in reducing maternal mortality and morbidity rates.

Gastrointestinal (GI) manifestations of lead poisoning include abdominal pain, constipation, and diarrhea. Depending on the severity of a symptom, surgical consultation is required. The present study aimed to make a comparison between the mean blood lead levels of patients hospitalized for lead toxicity and the various Gl symptoms. A retrospective cross-sectional study was performed in 2020 at Khorshid Hospital, the main regional referral center for poisoned patients (Isfahan, Iran). A total of 82 patients aged ≥18 years who were hospitalized for lead poisoning during 2017-2018 were included in the study. Patients’ information was extracted from hospital medical records, including demographic information, clinical manifestations, blood lead levels, and treatment outcome. The mean age of the patients was 48.18±11.9 years, 91.5% were men, and 62.2% suffered from multiple GI symptoms, with abdominal pain being predominant (31.7%). Blood lead levels in patients with multiple GI symptoms were higher than those with only one symptom (P=0.01). Surgical consultation was required in 14.6% of the patients. Multiple GI symptoms were the main predictive factor for blood lead levels above 70 mg/dL (P=0.03, Odds ratio=3.06, 95% CI=1.09-8.61). Given the prevalence of abdominal pain and its association with elevated blood lead levels, differential diagnosis of abdominal pain should include lead toxicity.

The effectiveness of eradicating Helicobacter pylori infection in improving the symptoms of chronic gastritis has been examined; however, the results of the studies have been contradictory, especially in childhood. This study aimed to compare the clinical effectiveness of sequential Helicobacter pylori eradication treatment and proton pump inhibitor alone in children with chronic Helicobacter pylori-positive gastritis.

This randomized double-blinded clinical trial was conducted on 84 children aged 5 to 15 years suffering from Helicobacter pylori-associated active chronic gastritis. The patients in the experimental group received sequential therapy including omeprazole, amoxicillin, clarithromycin, and metronidazole; and those in the control group only received omeprazole. Before the intervention, and 2 and 4 months after it, the severity of clinical symptoms was assessed.

After therapeutic regimens, the intervention group was found to have a significantly higher decrease in the severity grades of some symptoms including heartburn, gastroesophageal reflux, and abdominal pain in the epigastric area as compared to the control group (P<0.05). The assessment of the frequency of clinical symptoms in the intervention and control groups also indicated a greater reduction in epigastric pain in the group treated with Helicobacter pylori eradication as compared to the control group (P<0.05).

Prescribing a sequential Helicobacter pylori eradication regimen can lead to reducing the severity of clinical symptoms in children suffering from chronic gastritis.

Acute pancreatitis, a potentially fatal disease, with symptoms including nausea and/or vomiting, indigestion, and abdominal pain, is known to range from a mild self-limiting state up to a more severe and lethal form. This review aims toprovide a clearer picture to improve understanding the role of viral agents in the development of acute pancreatitis.Common databases including PubMed, Google Scholar, and Scopus were used for the literature search. In this review search terms including virus, viral, infection, and specific descriptive terms for a virus were considered in different combinations. Various causative agents are recognized in the development of acute pancreatitis as one of the most frequent gastrointestinal diseases, such as gallstones, alcoholism, and hypertriglyceridemia. Microbial pathogens with about 10% of acute pancreatitis cases, mainly viruses, among other factors, are thought to play a role in this regard. Once the pancreatitis diagnosis has been made, depending on thecausative agent, the management approach and specific interventions affect the final outcome. Virus-induced acute pancreatitis in patients should be considered. Advanced diagnostic tests such as PCR, in situ hybridization, and biopsy can help for a betterunderstanding of the role of viruses in causing acute pancreatitis. Improvement in the tests will lead to timely diagnosis, treatment, and better management of pancreatitis.

This case report presents the clinical course of a 54-year-old male patient diagnosed with posterior NutcrackerSyndrome (NCS). The patient experienced recurrent episodes of macroscopic hematuria and severe left flankpain. He was diagnosed with retro-aortic left renal vein (RLRV ), an unusual congenital abnormality, which canresult in the compression of the left renal vein between the aorta and the vertebra. Initial attempts at con-servative management and endovascular interventions were unsuccessful. An open surgical intervention wasultimately performed. The surgery involved ligation of the left renal vein. Postoperatively, the patient experi-enced marked improvement in symptoms, with complete resolution of hematuria and pain. Furthermore, renalfunction remained stable, and no kidney-related complications were reported. This case suggests that, in certainsituations where endovascular intervention and transposition of LRV or re-implantation of the left gonadal veinare not feasible, ligation of the LRV may provide a safe and practical treatment option for patients with posteriorNCS. Future research is needed to validate these findings.

Heterotopic pregnancy, a rare form of pregnancy, can occur Simultaneously intrauterine and extrauterine. This can be a life-threatening condition and can be easily overlooked if undiagnosed. The patient was a 27-year-old woman, gravid3, para1, live1 and abortion1, at 10 weeks and 1 day by last menstrual period who went to the emergency room complaining of pain in the lower abdomen form 3 days ago. Pelvic ultrasound revealed both live intrauterine and extrauterine pregnancy by gestational age based on the Crown-rump length diameter, 9 weeks and 3 days with moderate to severe hemoperitoneum. The heterotopic pregnancy diagnosis is difficult and requires a high index of suspicion.

 Due to the multi-factoriality of chronic abdominal pain (CAP) in children, this study aimed to assess the main etiologies for CAP in children and its main determinants in a sample of the community of affected children living in Shahrekord, Iran.

 This cross-sectional study was conducted on 400 children aged 3-14 years who were referred to a referral clinic in Shahrekord, Iran in 2022. Abdominal pain at least 3 times in 3 months, which disrupted daily activities, was the criterion for entering the study. A checklist was prospectively fulfilled by interviewing to assess different aimed data.

 The majority of children complained of periumbilical pain as the main site of chronic pain, and other pain points were much less common. The main characteristics that provided grounds for suspecting this type of pain included right abdominal pain without clear justification, growth disorder, and severe vomiting. The most common definitive diagnosis was functional constipation, followed by chronic gastritis and fecal impaction.

 The occurrence of periumbilical pain, along with the occurrence of severe and frequent vomiting and growth failure can be considered diagnostic markers triad when suspecting the occurrence of CAP. The most common etiologies for such pains included functional constipation, chronic gastritis, and fecal impaction.

Chronic abdominal pain is a frequent cause of surgical consultation. This study is conducted to evaluate usefulness of laparoscopy in diagnosis of chronic abdominal pain so as to reduce suffering and depression associated with condition. This study aims to define the role of diagnostic laparoscopy in chronic abdominal pain.

A hospital-based prospective study was conducted in the Department of Surgery, Shri Vasantrao Naik Government Medical College, Yavatmal, India,a tertiary care centerin the rural area from January 1, 2016 to June 30, 2017 with 50 patients to evaluate the role of laparoscopy in patients with chronic abdominal pain. All the patients underwent diagnostic laparoscopy with methodical inspection of the whole abdominal cavity.Statistical analysis was done using SPSS software.

The majority of the patients (36%) were in the age group of 21-30 years with women affected more (66%). The most common symptom was pain (100%) for more than 4-5 months. Laparoscopic findings were appendicitis (30%) followed by Koch’s abdomen (26%), adhesions (24%), sub-acute intestinal obstruction (SAIO) (8%), ovarian cyst (4%), and hernia (2%) which were treated accordingly. Resolution of pain was seen in 94% of the patients over a follow-up period of 3 months.

Diagnostic laparoscopy is a safe and effective procedure in the evaluation of patients with chronic abdominal pain in a rural area. It also provides an opportunity to perform the therapeutic procedure in the same setting thereby reducing the overall cost of treatment.

Adult-onset Still’s disease (AOSD) is a rare rheumatic disorder with various presentations. It is diagnosed based on the Yamaguchi criteria, besides the exclusion of infectious diseases and other rheumatic disorders and malignancies. Here, we describe a case of a young man, presenting with remittent fever, abdominal pain, and persistent nausea. Further evaluations showed elevated acute phase reactants, abnormal levels of liver transaminase, multiple lymphadenopathies, and pleural effusion. He was finally diagnosed with AOSD and responded well to corticosteroids and methotrexate. We describe the present case to alert gastroenterologists to AOSD as a rare differential diagnosis in patients with persistent gastrointestinal symptoms.

Lead poisoning is a problem in Iranian society. The most common symptoms of chronic lead poisoning are abdominal pain, constipation, and dysphagia. In this study, the blood lead level (BLL) of the patients, who referred to Besat Hospital, Hamadan, Iran with non-traumatic abdominal pain was evaluated. This is a case-control study in which 120 patients with abdominal pain, who referred to ED were divided into two groups. The first group of patients without exposure to lead (control) and the second group with exposure to lead (case), and then BLL were measured. Of 120 patients, 74 patients were male and 46 patients were female. The patients` mean age was 48.76 ± 17.12 years. The average BLL in the control group was 0.67 ± 1.38 μg/dL and in the case group was 1.61 ± 3.02 μg/dL (p<0.001). In the case group, 59 patients had a history of opium consumption and one was a building painter, whose average BLL was 1.63 ± 0.4 and 0 ± 0.3 μg/dL respectively. One patient from the control group and five patients from the case group had BLL higher than normal, but there was no statistical difference observed in both groups (p=0.207). lead poisoning among patients with abdominal pain, especially in opium addicts, should always be considered as a differential diagnosis.

Abdominal pain is one of the mostcommoncomplaints during pregnancy and is always debated due to its numerous differential diagnoses. Acute appendicitis is the most common complication requiring surgery during pregnancy.

The present study aimed to investigate symptoms, signs, and paraclinical findings in cases of pregnancy appendectomy within 2015 - 2019.

This retrospective study examined the frequency of appendectomy in pregnant women referring to Ali ibn Abi Talib Hospital of Zahedan in Iran. This study assessed 58 pregnantwomenwho referred to Ali Ebne-e Abitaleb hospital and underwent appendectomy from April 2015 to March 2019. Finally, the data were evaluated in terms of age, gravidity, gestational age, body temperature, clinical symptoms, complications of appendectomy, type of surgery, and white blood cells (neutrophil). For data analysis, the information was entered into SPSS software (version 22).

In the present study, the most common symptoms and signs of patients were tenderness and right lower quadrant (RLQ) pain (87.93%), nausea (75.9%), leukocytosis (72.4%), migration of pain (65.5%), vomiting (58.6%), and anorexia (53.4%). Additionally, the most common appendicitis trimester for appendicitis in pregnancy was the second thermistor (62.1%).

Tenderness in the RLQ area was the most important feature of appendicitis; however, nausea and leukocytosis were also common. Ultrasound was not a powerful imaging method due to the identification of less than half of the patients; nevertheless, the Alvarado score for acute appendicitis was helpful in numerous cases.

Isolated fallopian tube torsion is a rare situation in reproductive-aged women. The gold standard for diagnosis is laparoscopic evaluation, and the treatment of choice is salpingectomy without oophorectomy to preserve fertility. Still, inpatient with a presentation of the acute abdomen or hemodynamically unstable, urgent laparotomy is the treatment of choice. Here, we reported a 15-year-old virgin girl presented with acute abdominal pain and evidence of adnexal torsion on the abdominal ultrasonography. Urgent laparotomy revealed an isolated right fallopian tube torsion. Due to irreversible necrosis of the tube, right salpingectomy was performed. It's crucial to consider isolated fallopian tube torsion as a potential cause of abdominal pain in reproductive-aged women and use appropriate diagnostic measures to diagnose it early and preserve their future fertility.

Long-COVID refers to a collection of symptoms in COVID-19 patients which continue for at least 12 weeks after disease onset. The clinical manifestations are numerous and can affect nearly any organ of the body. Disease symptoms can be new or similar to that reported for acute COVID-19 and can occur in patients who had differing degrees of initial disease severity during acute infection.

The purpose of this study was to examine the effectiveness of logotherapy on mental pain, adherence to treatment, and abdominal pain in patients with irritable bowel syndrome.

The design of the current s tudy was quasi-experimental, which included three s tages of evaluation. In the firs t stage, the research questionnaires were completed by patients of both groups (pre-test). In the second stage, logotherapy was performed for eight sessions of 90 minutes with an interval of once a week on the experimental group by a psychotherapist (Ph.D in psychology and trained in therapy), and then the questionnaires were completed by the patients in both groups (post-test). In the third stage, 2 months after the end of the treatment sessions, the ques tionnaires were finally completed by the patients of both groups (follow-up).

There was a significant difference in reducing abdominal pain and increasing treatment adherence between the experimental and control groups in the post-test phase. These results were also stable in the follow-up phase (P>0.05).

Logotherapy reduced the mean of mental pain and abdominal pain and increased the mean of adherence to treatment in the post-test s tage. The effectiveness of treatment in the follow-up stage has also been stable. According to the results of the study, logotherapy is effective on the variables of mental pain, adherence to treatment, and abdominal pain in patients with the constipation-dominant type of irritable bowel syndrome. This type of psychotherapy can be used to examine other variables in such patients or in patients with other symptoms (diarrhea and mixed)

Lower abdominal or pelvic pain is a common complaint among women and one of the most challenging findings to evaluate. We performed the present study to construct a new algorithm for predicting the chance of ovarian torsion among women with acute lower abdominal pain.

This diagnostic retrospective cross-sectional study was performed on all female individuals who were referred to Imam Hossein Medical Center, Tehran, Iran, with the chief complaint of acute lower abdominal pain, and underwent laparotomy between 2010 and 2016. Clinical and paraclinical findings were evaluated to construct a predictive model for ovarian torsion. The variables were compared in 2 groups. The first group included individuals with a final diagnosis of ovarian torsion and the second group included those individuals with any diagnosis other than ovarian torsion. All data were compared between these 2 groups using SPSS software Version 21 to find the related findings with a predictive value for ovarian torsion.

A total of 372 participants were evaluated, of whom 116 participants (31.2%) had ovarian torsion (case group) and 256 participants had other diagnoses for their lower abdominal pain (control group). Nausea and vomiting (p < 0.001), tenderness (p < 0.001), the size of ovarian mass (p = 0.004), and the percentage of polymorphonuclear (p < 0.001) showed significant relationships with ovarian torsion as the final diagnosis. Multiple logistic regression models were constructed to predict the factors affecting ovarian torsion, and a scoring system was designed to predict ovarian torsion, with a sensitivity of 77.59% (68.9%- 84.8%) and specificity of 74.61% (68.8% 79.8%).

The proposed model is suitable for predicting ovarian torsion and its necessary information is readily available from individuals’ history, examination findings, laboratory results, and an ultrasound exam.