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Abdominal Wall Pain Causes

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1. CRACKCast E095 – Large Intestine

….translocation of bacteria..from a compromised bowel can lead to sepsis. Perforation of the bowel wall follows if the process is not interrupted.” – From Rosen’s. In these patients, the rectal exam is crucial – because you may find a hard mass or stool, which may explain the cause for the obstruction! Management: Rehydration Electrolyte replacement Pain and nausea control Antibiotics (if perforated, sick, etc.) Gastric decompression and NPO Surgical consultation 6) What are the four types of GI volvulus (...) ! IBS Diverticular disease Volvulus Large bowel obstruction IBD Intussusception Colonic ischemia Radiation proctocolitis 1) List features that are typical for IBS. This is a chronic, non-life threatening disorder – causing abdo pain and weird bowel habits. 10-15% prevalence, and it is thought to impair one’s QOL more than diabetes or renal failure!!! Its defined as a “functional, somatic syndrome” because there are no physical or lab features that clinch the diagnosis! No known cause. Testing shows

2017 CandiEM

2. Surgery for intra-abdominal abscess due to intestinal perforation caused by toothpick ingestion: Two case reports. Full Text available with Trip Pro

Surgery for intra-abdominal abscess due to intestinal perforation caused by toothpick ingestion: Two case reports. Failure to pass though the gastrointestinal tract can result in inflammatory response, reactive fibrosis, and intestinal perforation. Fish bones, chicken bones, and toothpicks are the most common types of foreign substances that produce intestinal perforation during ingestion.Case 1: A 49-year-old female was hospitalized with abdominal pain and a fever. The fever lasted for 5 days (...) before hospitalization. Case 2: A 72-year-old male was hospitalized with abdominal pain and fever. The fever lasted for 4 days before hospitalization.Case 1: An abdominal pelvic computed tomography (APCT) scan revealed a large inflammatory mass formation and linear high-density material within the inflammatory mass. The presence of foreign bodies, including acupuncture needles or intrauterine devices was ruled out. Case 2: An APCT scan revealed that there was a small abscess formation measuring about

2019 Medicine

3. Rare intestinal fistula caused by primary lymphoma of the gastrointestinal tract: Two case reports and literature review. Full Text available with Trip Pro

and abdominal pain for seven months underwent computed tomography enterography (CTE) that demonstrated ileum internal fistula and ileac-sigmoid colon fistula. Ultrasound (US) showed small intestinal wall thickened and development of a fistula of the sigmoid colon due to malignance. Patient 2: A 43-year-old male presented with abdominal pain and diarrhoea lasting one year. US revealed a fistula between the sigmoid colon and the ileum, and CTE showed that the wall of the partial sigmoid colon was abnormally (...) Rare intestinal fistula caused by primary lymphoma of the gastrointestinal tract: Two case reports and literature review. Primary lymphoma that arises from the intestine is an uncommon malignant tumour, while intestinal fistula caused by primary lymphoma is even rarer. Non-specific clinical performance makes early diagnosis difficult, although imaging modalities might play an essential role in the detection of intestinal fistula.Patient 1: A 60-year-old male hospitalized with diarrhoea

2018 Medicine

4. Chronic Abdominal Wall Pain: A Common Yet Overlooked Etiology of Chronic Abdominal Pain. Full Text available with Trip Pro

Chronic Abdominal Wall Pain: A Common Yet Overlooked Etiology of Chronic Abdominal Pain. Chronic abdominal wall pain is a common, yet often overlooked, cause of chronic abdominal pain in both the outpatient and inpatient settings. This disorder most commonly affects middle-aged adults and is more prevalent in women than in men. In chronic abdominal wall pain, the pain occurs due to entrapment of the cutaneous branches of the sensory nerves that supply the abdominal wall. Although the diagnosis (...) of chronic abdominal wall pain can be made using patient history, physical examination, and response to a trigger point injection, patients often undergo extensive and exhaustive laboratory, imaging, and procedural work-up before being diagnosed with this condition, given it is often overlooked. Carnett's sign is a specialized physical examination technique that can help support the fact that the abdominal pain originates from the abdominal wall rather than from the abdominal viscera. The mainstay

2019 Mayo Clinic Proceedings

5. Prolonged Epigastric Pain Caused by a Leaf Stem Embedded in the Gastric Wall Full Text available with Trip Pro

Prolonged Epigastric Pain Caused by a Leaf Stem Embedded in the Gastric Wall A 67-year-old woman underwent esophagogastroduodenoscopy to determine the cause of her prolonged epigastric pain. During the examination, a sharp-pointed foreign body was observed; the edge of the object had been embedded in the gastric wall. The object was removed via an endoscope, and the patients' symptoms improved immediately. Based on a dietary history and an electron microscope examination, we identified (...) the object as a stem of mizuna, a potherb mustard. Our report indicates that commonly eaten leafy green vegetables can act as sharp-pointed foreign bodies with the potential to injure the upper gastrointestinal tract.

2018 Internal Medicine

6. Exercise-Induced Abdominal Wall Muscle Injury Resulting in Rhabdomyolysis and Mimicking an Acute Abdomen. (Abstract)

Exercise-Induced Abdominal Wall Muscle Injury Resulting in Rhabdomyolysis and Mimicking an Acute Abdomen. Rhabdomyolysis is characterized by muscle necrosis and release of intracellular constituents, causing muscle pain, weakness, and myoglobinuria. This can be attributed to muscle injury after strenuous exercise. If the abdominal wall is involved, clinical presentation may resemble an acute abdomen.A 27-year-old woman, gravida 4 para 2, presented with swelling and pain of the mons pubis (...) and abdominal pain after intense powerlifting 2 days prior. A computed tomography scan was performed, revealing abdominal wall inflammation. Although myoglobinuria was absent, there was high suspicion for rhabdomyolysis, which was confirmed by an elevated creatine kinase level. The patient improved after receiving intravenous fluids and abstaining from physical activity.Abdominal wall muscle injury resulting in rhabdomyolysis can imitate an acute abdomen in a healthy woman presenting with abdominal pain

2018 Obstetrics and Gynecology

7. Single Balloon Enteroscopy System for Obscure GI Bleeding (Small Bowel)

. Lay summary Patients with obscure gastrointestinal (GI) bleeding – that is, bleeding where the cause is not determined from initial medical procedures examining the GI tract – may be further investigated with balloon enteroscopy. A balloon enteroscope allows for a detailed investigation of the small bowel. Currently, MBS items are available for procedures using a double balloon technique. The application requested that a single balloon technique be included on the MBS. The available evidence (...) Single Balloon Enteroscopy System for Obscure GI Bleeding (Small Bowel) A Spons Date o 1. P An appl balloon (GI) ble Decemb SBE ca same pr For SBE the endo bowel w inserted straight the over similar with air Double gastroin of two b the endo (via an then inf balloon further SBE dif balloon DBE . B the addi Applicati sor/Applica of MSAC c Purpose of lication req n enteroscop eeding was ber 2011. an be perform reparation a E, a 200-cen oscope. The wall it ancho d more deep ter, allowing r-tube

2013 Medical Services Advisory Committee

8. A case of intestinal obstruction due to inflammatory changes in the small intestine from alkaline ingestion Full Text available with Trip Pro

A case of intestinal obstruction due to inflammatory changes in the small intestine from alkaline ingestion Alkaline ingestion frequently causes corrosive esophagitis but rarely causes lower digestive tract injury. In this case, a 79-year-old man accidentally drank kitchen detergent. After 3 h, lower abdominal pain occurred and gradually worsened. He was taking a proton pump inhibitor after proximal gastrectomy for gastric cancer. He had local tenderness in the left lower abdomen. Abdominal (...) computed tomography showed expansion of the small intestine, thickening of the intestinal wall, and inflammatory changes. Upper gastrointestinal endoscopy showed no obvious injury to the esophagus or stomach.Conservative treatment with an ileus tube was undertaken for intestinal obstruction caused by alkaline ingestion. There were no complications, such as gastrointestinal perforation, and he was discharged on day 17.Alkaline ingestion may cause injuries not only to the upper but also to the lower

2018 Acute medicine & surgery

9. Small Intestinal Bacterial Overgrowth

. INTRODUCTION Small intestinal bacterial overgrowth (SIBO) has been recognized as a medical phenomenon for many decades. Although its definition has been debated, the principle concept is that the normal small bowel has lower levels of microbial colonization compared with the colon and this normal balance is significantly altered in SIBO. SIBO is defined as the presence of excessive numbers of bacteria in the small bowel causing gastrointestinal (GI) symptoms. These bacteria are usually coliforms, which (...) retrograde movement of colonic contents resulting in colonization of the small bowel with bacteria normally found in the large intestine ( ). Studies in patients with anatomical risk factors from intrinsic causes such as small bowel diverticulosis or fistula formation or iatrogenic consequences such as post–Roux-en-Y, ileocolonic anastomosis, or post–radiation stricture/adhesion formation have all shown a higher prevalence of SIBO ( ). Advanced age and female gender are also associated with a higher

2020 American College of Gastroenterology

10. Bowel wall thickening: inquire or not inquire? Our guidelines Full Text available with Trip Pro

, esophagogastroduodenoscopy or capsule endoscopy) are performed.We conducted a retrospective study on data collected from May 2016 to June 2017. We selected 40 adult patients, admitted in Emergency Department with "abdominal pain" and undergone an abdomen CT scan, in which bowel wall abnormalities were founded.75% patients were found to have a benign condition vs 25% a malignant condition. In the stomach group, 50% were found to have a neoplasm, whilst 33.3% presented an aspecific pattern and 16.7% had an inflammatory (...) Bowel wall thickening: inquire or not inquire? Our guidelines Bowel wall thickening is not an uncommon finding among patient undergoing abdomen CT scan. It may be caused by neoplastic, inflammatory, infectious or ischaemic conditions but also be a normal variant. Although specific radiologic patterns may direct to a precise diagnosis, occasionally misidentification may occur. Thus, in the absence of guidelines, further and not always needed diagnostic procedures (colonoscopy

2018 Il Giornale di chirurgia

11. Abdominal Wall Pain: A Common Clinical Problem. Full Text available with Trip Pro

Abdominal Wall Pain: A Common Clinical Problem. Abdominal wall pain (AWP) is a common and underrecognized cause of chronic abdominal pain. The etiology of AWP varies. History and physical examination are critical to an accurate diagnosis of AWP. Trigger point injection using either a corticosteroid, a local anesthetic, or a combination of both often gives relief of pain and is of diagnostic and therapeutic value. Increased awareness of AWP as a cause of chronic, nonvisceral abdominal pain can (...) prevent fruitless searches for intra-abdominal pathology and reduce medical costs.Copyright © 2018 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

2019 Mayo Clinic Proceedings

12. Abdominal Wall Pain Causes

Abdominal Wall Pain Causes Abdominal Wall Pain Causes Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Abdominal Wall Pain Causes (...) Abdominal Wall Pain Causes Aka: Abdominal Wall Pain Causes , Abdominal Muscle Wall Pain Causes From Related Chapters II. Causes: Hernia Abdominal Wall or (rare) Transversus aponeurosis defect at lateral rectus abdominis inferior to arcuate line III. Causes: Neuropathy Mononeuritis multiplex (Diabetic Thoracic Polyradiculopathy) Severe nerve root T6 to T12 truncal pain Nerve root compression or impingement Radiculopathy Spinal level T7 to L1 Nerve Roots Ilioinguinal nerve root entrapment

2018 FP Notebook

13. Stool filling of an intestinal duplication cyst at the ileocecal valve triggers colonic intussusception: a case report Full Text available with Trip Pro

abdominal pain. Computed tomography revealed colonic intussusception induced by a nodular mass in the ileocecal region. Urgent ileocecal resection was performed because of the risk of colonic ischemia. The resected material comprised a stool-filled noncommunicating cyst that protruded into the enteric lumen at the ileocecal valve. Histological analyses revealed that the inner wall of the cyst was lined with colonic mucosa and that the muscle layer of the cyst was shared with that of the original enteric (...) Stool filling of an intestinal duplication cyst at the ileocecal valve triggers colonic intussusception: a case report Intestinal duplication, a congenital malformation, is considered a rare condition, particularly in adults. Although it affects young children, a minority of patients remains asymptomatic until adulthood. Here, we describe a case of an intestinal duplication cyst that caused intussusception by a unique mechanism.A 19-year-old man was admitted to our hospital for intermittent

2018 Surgical Case Reports

14. A Case of Fatal Colonic Perforation without Abdominal Exam Findings

A Case of Fatal Colonic Perforation without Abdominal Exam Findings Spotlight: A Case of Fatal Colonic Perforation without Abdominal Exam Findings – Clinical Correlations Search Spotlight: A Case of Fatal Colonic Perforation without Abdominal Exam Findings June 14, 2018 6 min read By Christopher Sonne, MD Peer reviewed Learning Objectives: 1. Understand the pathophysiology of peritonitis secondary to bowel perforation. 2. Understand how classic findings of peritonitis can be absent in some (...) cases of bowel perforation. 3. Recognize bowel perforation as a complication requiring emergent surgical intervention. Case: An 89 year-old woman with a history of chronic constipation was admitted for several weeks of severe constipation and abdominal bloating. On initial exam, she exhibited abdominal distention but had minimal abdominal tenderness. Initial CT imaging demonstrated a significant stool burden with prominent colonic distension extending from the cecum to the transverse colon. She had

2018 Clinical Correlations

15. Abdominal Cutaneous Nerve Entrapment Syndrome: The Cause of Localized Abdominal Pain in a Young Pregnant Woman. (Abstract)

Abdominal Cutaneous Nerve Entrapment Syndrome: The Cause of Localized Abdominal Pain in a Young Pregnant Woman. Despite the broad differential diagnosis in any patient referring with symptoms involving the chest or abdomen, a small number of conditions overshadow the rest by their probability. Chest and abdominal wall pain continues to constitute a common and expensive overlooked source of pain of unknown cause. In particular, cutaneous nerve entrapment syndrome is commonly encountered (...) but not easily diagnosed unless its specific symptoms are sought and the precise physical examination undertaken.A primigravida woman with unbearable abdominal pain was referred repeatedly seeking a solution for her suffering. Numerous laboratory and imaging studies were employed in order to elucidate the cause of her condition. After numerous visits and unnecessary delay, the diagnosis was finally made by a physician fully versed in the field of torso wall pain. The focused physical examination disclosed

2018 Journal of Emergency Medicine

16. Coping with Common GI Symptoms in the Community: A Global Perspective on Heartburn, Constipation, Bloating, and Abdominal Pain/Discomfort

examination should be carried out, and one should consider pelvic ultrasound and/or referral to a gynecologist. Table 1 Pain location and differential diagnosis Pain location Indication of origin Possible diagnosis Epigastric, upper abdominal Esophageal, stomach, duodenal, gallbladder, pancreatic GERD, gastritis, duodenal or gastric ulcer, cholecystitis, pancreatitis Large bowel—lateralization: Left: descending/sigmoid colon Diverticulitis Lower abdominal Right: ascending colon/cecum, appendix Crohn’s (...) Europe/Western countries • Functional disorders of the gastrointestinal tract are estimated to occur in up to 30% of the adult population in Western countries [6,7] and are recognized as a frequent cause of abdominal pain. Only 20–50% of these symptoms can be formally attributed to IBS [1,8]. • In IBS, abdominal pain and/or discomfort is the central symptom; other intestinal symptoms are altered bowel habit, which may be dominated by constipation or diarrhea or may alternate between them, as well

2013 World Gastroenterology Organisation

17. A Rare Cause of Abdominal Pain in a Patient with Acute Necrotizing Pancreatitis Full Text available with Trip Pro

A Rare Cause of Abdominal Pain in a Patient with Acute Necrotizing Pancreatitis Walled-off necrosis (WON) is a potentially lethal late complication of acute pancreatitis (AP) and occurs in less than 10% of AP cases. It can be located in or outside the pancreas. When infected, the mortality rate increases and can reach 100% if the collection is not drained. Its treatment is complex and includes, at the beginning, intravenous antibiotics, which permit sepsis control and a delay in the therapeutic (...) intervention, like drainage. Nowadays, a minimally invasive approach is advised. Depending on the location of the collection, computed tomography (CT)-guided drainage or endoscopic necrosectomy are the primary options, then complemented by surgical necrosectomy if needed. Infected WON of the abdominal wall has been rarely described in the literature and there is no report of any infection with Citrobacter freundii.We present the case of a 61-year-old man with necrotizing AP complicated by WON of the left

2017 GE Portuguese journal of gastroenterology

18. Assessment of chronic abdominal pain

Nephrolithiasis Pelvic inflammatory disease (PID) Irritable bowel syndrome Gastroparesis Functional dyspepsia Centrally mediated abdominal pain syndrome (CAPS) Chronic abdominal wall pain Referred pain Crohn's disease Ulcerative colitis Subacute intestinal obstruction Coeliac disease Chronic pancreatitis Oesophageal cancer Gastric cancer Colorectal cancer Pancreatic cancer Hepatocellular cancer Cholangiocarcinoma Chronic mesenteric ischaemia Superior mesenteric artery syndrome Acute intermittent porphyria (...) ?tool=bestpractice.com Talley NJ. Irritable bowel syndrome: definition, diagnosis and epidemiology. Baillieres Best Pract Res Clin Gastroenterol. 1999;13:371-384. http://www.ncbi.nlm.nih.gov/pubmed/10580915?tool=bestpractice.com Halder SL, McBeth J, Silman AJ, et al. Psychosocial risk factors for the onset of abdominal pain. Results from a large prospective population-based study. Int J Epidemiol. 2002;31:1219-1225. http://ije.oxfordjournals.org/cgi/content/full/31/6/1219 http://www.ncbi.nlm.nih.gov

2018 BMJ Best Practice

19. Assessment of abdominal pain in pregnancy

about the health of their fetus. Patients require a careful assessment in order to reduce anxiety and give reassurance. If the clinical picture is unclear, a specialist should be consulted. Chamberlain G. ABC of antenatal care: abdominal pain in pregnancy. BMJ. 1991;302:390-1394. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1670063/pdf/bmj00129-0073.pdf http://www.ncbi.nlm.nih.gov/pubmed/2059722?tool=bestpractice.com Augustin G, Majerovic M. Non-obstetrical acute abdomen during pregnancy. Eur J (...) Obstet Gynecol Rep Biol. 2007;131:4-12. http://www.ncbi.nlm.nih.gov/pubmed/16982130?tool=bestpractice.com Diagnostic challenges and pitfalls The physiological and anatomical changes of various organs during the course of pregnancy result in major diagnostic challenges for the clinician. Reproductive organs share the same visceral innervations as the lower ileum, sigmoid colon, and rectum. It is therefore often difficult to differentiate between pain of gynaecological and GI origin. Pain may be due

2018 BMJ Best Practice

20. Treatment of Painful Nerves in the Abdominal Wall Using Processed Nerve Allografts Full Text available with Trip Pro

Treatment of Painful Nerves in the Abdominal Wall Using Processed Nerve Allografts Neuromas can be a debilitating cause of pain and often negatively affect patients' quality of life. One effective method of treatment involves surgical resection of the painful neuroma and use of a processed nerve allograft to repair the injured nerve segment. Giving the nerve "somewhere to go and something to do" has been shown to effectively alleviate pain in upper and lower extremities. We present the first (...) report of this concept to treat a painful neuroma of the abdominal wall that developed following a laparoscopic gastric bypass. The neuroma was excised, and the affected nerve was reconstructed using a processed nerve allograft as an interposition graft, with resolution of pain and gradual return of normal sensation. Patient-reported outcomes were measured using the Patient Reported Outcomes Measurement Information System. Neuroma excision with concurrent interposition grafting using processed nerve

2018 Plastic and Reconstructive Surgery Global Open

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