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Annals of Emergency Medicine Apr 2022
Topics: Abdominal Pain; Diagnosis, Differential; Fever; Humans; Male
PubMed: 35337472
DOI: 10.1016/j.annemergmed.2021.10.003 -
Radiologic Clinics of North America Jul 2019Acute abdominopelvic pain, a common symptom in emergency department patients, is challenging given the spectrum of differential diagnoses encompassing multiple organ... (Review)
Review
Acute abdominopelvic pain, a common symptom in emergency department patients, is challenging given the spectrum of differential diagnoses encompassing multiple organ systems, ranging from benign self-limiting to life-threatening and emergent. Diagnostic imaging is critical given its high accuracy and management guidance. A contrast-enhanced computed tomography (CT) scan is preferred given its widespread availability and speed of acquisition. MR imaging may be appropriate, usually performed for specific indications with tailored protocols. It is accurate for diagnosis and may be an alternative to CT. This article discusses the advantages and disadvantages, protocols, and appearances of MR imaging of common diagnoses.
Topics: Abdominal Pain; Acute Disease; Digestive System Diseases; Emergencies; Humans; Magnetic Resonance Imaging
PubMed: 31076027
DOI: 10.1016/j.rcl.2019.02.010 -
Annals of Emergency Medicine Jul 2022
Topics: Abdominal Pain; Female; Humans
PubMed: 35717124
DOI: 10.1016/j.annemergmed.2022.01.021 -
Emergency Medicine Clinics of North... May 2020Abdominal and extremity complaints are common in the emergency department (ED) and, because of their frequency, clinical vigilance is vital in order not to miss the... (Review)
Review
Abdominal and extremity complaints are common in the emergency department (ED) and, because of their frequency, clinical vigilance is vital in order not to miss the timely diagnosis of occult or delayed emergencies. Such emergencies, if not timely managed, are sources of significant patient morbidity and mortality and may expose ED physicians to possible litigation. Each patient complaint yields to a nuanced approach in diagnostics and therapeutics that can lead physicians toward the ruling in or out of the correct high-risk diagnosis. This article discusses the approach and risk management of this high-risk subset of abdominal and extremity diagnoses.
Topics: Abdominal Pain; Arm Injuries; Emergency Service, Hospital; Humans; Leg Injuries; Malpractice; Risk Management
PubMed: 32336337
DOI: 10.1016/j.emc.2020.02.005 -
Gastrointestinal Endoscopy Clinics of... Jan 2019Gastroparesis is a chronic and debilitating neuromuscular disorder of the upper gastrointestinal tract. Symptoms of gastroparesis include nausea, vomiting, epigastric... (Review)
Review
Gastroparesis is a chronic and debilitating neuromuscular disorder of the upper gastrointestinal tract. Symptoms of gastroparesis include nausea, vomiting, epigastric pain, early satiety, and weight loss. Treating gastroparesis can be difficult. Dietary changes may improve symptoms in patients with mild disease. A variety of medications can be used to treat symptoms of nausea and vomiting, although most have not been subjected to randomized controlled trials and only one is approved by the Food and Drug Administration (metoclopramide). Pain management is essential, as nearly 90% of patients report symptoms of epigastric pain. This article reviews treatment options for symptoms of gastroparesis.
Topics: Abdominal Pain; Gastroparesis; Humans
PubMed: 30396528
DOI: 10.1016/j.giec.2018.08.005 -
Expert Review of Gastroenterology &... Jan 2019Functional dyspepsia (FD), defined by the Rome consensus as the presence of functional symptoms originating from the gastroduodenum, is one of the most common functional... (Review)
Review
Functional dyspepsia (FD), defined by the Rome consensus as the presence of functional symptoms originating from the gastroduodenum, is one of the most common functional gastrointestinal disorders. FD is subdivided into postprandial distress syndrome (PDS), with meal-related symptoms such as postprandial fullness and early satiation, and epigastric pain syndrome (EPS), with meal-unrelated symptoms such as epigastric pain or burning. We used a literature search for a narrative review on the current state of knowledge regarding PDS. Areas covered: Epidemiological studies support PDS as a separate entity and the biggest FD subgroup. The pathophysiology of PDS is heterogeneous, and disorders of gastric sensorimotor function as well as low grade duodenal inflammation have been implicated. Although prokinetic agents may provide the most pathophysiology-oriented treatment option, there is a paucity of suitable agents, and proton pump inhibitors are the traditional first-line therapy. Other options include agents that enhance gastric accommodation, such as acotiamide and 5-HT agonists, neuromodulators such as mirtazapine, and traditional medicine approaches. Expert commentary: PDS is highly prevalent, with probably heterogeneous underlying pathophysiology. Motility modifying agents and neuromodulators are the cornerstone of PDS therapy, but there is a need for high quality studies of new therapeutic approaches.
Topics: Abdominal Pain; Feeding Behavior; Gastrointestinal Agents; Gastrointestinal Diseases; Humans; Postprandial Period; Prevalence; Risk Factors; Satiation; Syndrome; Treatment Outcome
PubMed: 30791841
DOI: 10.1080/17474124.2019.1543586 -
Expert Review of Gastroenterology &... May 2018Functional abdominal pain disorders, including irritable bowel syndrome, are common in children and treatment can often be difficult. Pharmacological therapies and... (Review)
Review
Functional abdominal pain disorders, including irritable bowel syndrome, are common in children and treatment can often be difficult. Pharmacological therapies and complementary treatments are widely used, despite the limited data in pediatrics. Areas covered: This review provides an overview of the available data for the use of diet, probiotics, percutaneous electrical nerve stimulation, and psychosocial interventions, including hypnotherapy, yoga, cognitive and behavioral therapy, and mind-body interventions for the treatment of functional abdominal pain disorders in children. The literature review included a PubMed search by each therapy, children, abdominal pain, and irritable bowel syndrome. Relevant articles to this review are discussed. Expert commentary: The decision on the use of pharmacological and complementary therapies should be based on clinical findings, evidence, availability, and in-depth discussion with the patient and family. The physician should provide education on the different interventions and their role on the treatment in an empathetic and warm manner providing ample time for the family to ask questions.
Topics: Abdominal Pain; Age of Onset; Humans; Irritable Bowel Syndrome; Pain Management; Pain Measurement; Risk Factors; Treatment Outcome
PubMed: 29633902
DOI: 10.1080/17474124.2018.1462699 -
The British Journal of Radiology Aug 2022Abdominal pain in pregnancy is a diagnostic challenge with many potential aetiologies. Diagnostic imaging is a valuable tool in the assessment of these patients, with... (Review)
Review
Abdominal pain in pregnancy is a diagnostic challenge with many potential aetiologies. Diagnostic imaging is a valuable tool in the assessment of these patients, with ultrasound commonly employed first line. MRI is an excellent problem-solving adjunct to ultrasound and has many advantages in terms of improved spatial resolution and soft tissue characterisation. This pictorial review aims to outline the role of MRI in the work up of acute abdominal pain in pregnancy and provide imaging examples of pathologies which may be encountered.
Topics: Abdomen, Acute; Abdominal Pain; Female; Humans; Magnetic Resonance Imaging; Pregnancy; Pregnancy Complications; Ultrasonography
PubMed: 35604640
DOI: 10.1259/bjr.20211114 -
Current Problems in Pediatric and... Aug 2020Chronic abdominal pain is a common problem seen by pediatricians and pediatric gastroenterologist alike. There should not be evidence of underlying organic pathology,... (Review)
Review
Chronic abdominal pain is a common problem seen by pediatricians and pediatric gastroenterologist alike. There should not be evidence of underlying organic pathology, with diagnosis based upon the Rome IV criteria. Although it frequently occurs, routine diagnostic testing is not always necessary. Providing assurance and helpful coping strategies is key in the management of chronic abdominal pain. Sometimes other expertise is needed when developing these strategies.
Topics: Abdominal Pain; Age Factors; Cognitive Behavioral Therapy; Diet; Humans; Patient Education as Topic; Pediatrics; Physical Examination; Referral and Consultation; Severity of Illness Index
PubMed: 32859509
DOI: 10.1016/j.cppeds.2020.100840 -
Nederlands Tijdschrift Voor Geneeskunde 2015Splenosis is a common benign finding that occurs after splenic trauma or after splenectomy. It is auto-transplantation of splenic tissue and can be seen... (Review)
Review
Splenosis is a common benign finding that occurs after splenic trauma or after splenectomy. It is auto-transplantation of splenic tissue and can be seen intra-abdominally, intra-thoracically and even subcutaneously. Splenosis is usually found incidentally at laparoscopy, laparotomy or on radiological examination and is mostly asymptomatic. Treatment is only required if a patient complains of abdominal pain, obstruction or bleeding. On radiological examination splenosis can mimic a metastatic malignant disease. For this reason it is important to recognise splenosis and know the patient's medical history concerning splenic trauma or splenectomy, thus avoiding diagnostic laparoscopy or ultrasound guided biopsy. This paper presents two patients with splenosis. Additionally, we describe how to diagnose this entity by scintigraphy with (99m) Technetium-labelled heat-denatured erythrocytes.
Topics: Abdominal Injuries; Abdominal Pain; Adult; Aged; Diagnosis, Differential; Female; Humans; Laparoscopy; Laparotomy; Male; Splenectomy; Splenosis
PubMed: 26104005
DOI: No ID Found