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Epigastric Pain

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1. A 40-something male with epigastric pain

A 40-something male with epigastric pain Dr. Smith's ECG Blog: A 40-something male with epigastric pain Wednesday, January 24, 2018 A 40-something male presented with epigastric pain. An ECG was recorded immediately (time zero): This was texted to me asking for my opinion. What do you think? My answer: Normal variant He had serial ECGs: This was recorded at t = 40 minutes: Subsequently, the patient was diagnosed with cholecystitis . This was recorded at t = 110 minutes Notice there is some (...) Ghali ( @EM_RESUS ). A 60-year-old man calls 911 after experiencing sudden onset chest pain, palpitations, a... Written by Pendell Meyers, with edits by Steve Smith Thanks to my attending Nic Thompson who superbly led this resuscitation We receive... This was sent by a recent ultrasound fellow, asking for my ECG diagnosis. He stated that it is "an acute change from previous" ... Written by Pendell Meyers, with edits from Steve Smith Let's consider this nearly pathognomonic ECG without the clinical

2018 Dr Smith's ECG Blog

2. Unusual Cause of Epigastric Pain: Intra-Abdominal Focal Fat Infarction Involving Appendage of Falciform Ligament - Case Report and Review of Literature (PubMed)

Unusual Cause of Epigastric Pain: Intra-Abdominal Focal Fat Infarction Involving Appendage of Falciform Ligament - Case Report and Review of Literature Torsion of the fatty appendage of the falciform ligament, part of the spectrum of conditions known as intra-abdominal focal fat infarction (IFFI), is very rare with less than 20 cases reported on imaging so far. Here we report a case of torsion of the lipomatous appendage of the falciform ligament in a middle-aged female, diagnosed on ultrasound

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2017 GE Portuguese journal of gastroenterology

3. A Rare Cause of Acute Epigastric Pain During Late Pregnancy. (PubMed)

A Rare Cause of Acute Epigastric Pain During Late Pregnancy. A 20-year-old woman with 36 weeks of gestation presented with acute persistent epigastric pain for two days. Physical examination demonstrated skin jaundice, sclera icterus and upper abdominal tenderness without rebound tenderness. Laboratory examinations showed the serum concentration of hemoglobin, total bilirubin and direct bilirubin were 86.0 g/L, 60.9 μmol/L and 42.1 μmol/L, respectively. Results of fetal monitoring

2019 Liver International

4. Epigastric Pain, Vomiting, and Cardiac Arrhythmias. (PubMed)

Epigastric Pain, Vomiting, and Cardiac Arrhythmias. A woman with epigastric pain and nausea had atrioventricular block confined to episodes of vomiting.Copyright © 2019 Elsevier Inc. All rights reserved.

2019 American Journal of Cardiology

5. A comparative study of postoperative port-site pain after gallbladder retrieval from umbilical versus epigastric ports in laparoscopic cholecystectomy. (PubMed)

A comparative study of postoperative port-site pain after gallbladder retrieval from umbilical versus epigastric ports in laparoscopic cholecystectomy. Gall bladder (GB) retrieval is an important cause for postoperative pain after laparoscopic cholecystectomy (LC). GB is usually extracted either from the epigastric or the umbilical port and there are limited data to decide the superiority of one over other in terms of postoperative pain. This study was designed to determine whether GB retrieval (...) from the umbilical port was associated with less pain as compared to epigastric port in adult patients undergoing four ports elective LC.A total of 100 patients took part in the study and were randomly allocated into 2 groups. Postoperatively, port-site pain score was assessed at 1, 6, 12, and 24 h by visual analog scale (VAS) score both for the epigastric and umbilical ports in all the patients and the collected data were analyzed by using SPSS version 22.VAS score for postoperative pain

2019 Journal of family medicine and primary care Controlled trial quality: uncertain

6. Case Report: Severe back pain, epigastric distress and refractory nausea; an unusual presentation of mediastinal bronchogenic cyst (PubMed)

Case Report: Severe back pain, epigastric distress and refractory nausea; an unusual presentation of mediastinal bronchogenic cyst Background: Bronchogenic cysts are congenital malformations from abnormal budding of embryonic foregut and tracheobronchial tree. We present a case of bronchogenic cyst with severe back pain, epigastric distress and refractory nausea and vomiting.   Case Presentation: A 44-year-old Hispanic female presented with a 3-week history of recurrent sharp interscapular pain (...) primary cysts of mediastinum with the prevalence of 6%. The most common symptoms are chest pain, dyspnea, cough, and stridor. Diagnosis is made by chest X-Ray and CT chest. Magnetic resonance imaging chest and EBUS are more sensitive and specific. Symptomatic cysts should be resected unless surgical risks are high. Asymptomatic cysts in younger patients should be removed due to low surgical risk and potential late complications. Watchful waiting has been recommended for asymptomatic adults or high

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2018 F1000Research

7. MKSAP: 41-year-old woman with burning epigastric and chest pain

MKSAP: 41-year-old woman with burning epigastric and chest pain Observation is recommended for adult patients with asymptomatic gallstones MKSAP: 41-year-old woman with burning epigastric and chest pain | | April 7, 2018 2 Shares Test your medicine knowledge with the , in partnership with the . A 41-year-old woman is evaluated in follow-up after presenting to the emergency department 1 week ago for burning epigastric and chest pain. In the emergency department, a complete blood count and liver (...) Hire KevinMD to keynote your next event "Kevin's keynote presentation was perfect. Extremely rich in content, and a delivery that is world class." Related Posts More in Conditions < Previous post Next post > Find jobs at Careers by KevinMD.com Search thousands of physician, PA, NP, and CRNA jobs now. × MKSAP: 41-year-old woman with burning epigastric and chest pain 1 comments Comments are moderated before they are published. Please read the . Leave a Comment Name Email Website Comment Close X Most

2018 KevinMD blog

8. Prolonged Epigastric Pain Caused by a Leaf Stem Embedded in the Gastric Wall (PubMed)

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

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2018 Internal Medicine

9. Camostat Mesilate, Pancrelipase, and Rabeprazole Combination Therapy Improves Epigastric Pain in Early Chronic Pancreatitis and Functional Dyspepsia with Pancreatic Enzyme Abnormalities. (PubMed)

Camostat Mesilate, Pancrelipase, and Rabeprazole Combination Therapy Improves Epigastric Pain in Early Chronic Pancreatitis and Functional Dyspepsia with Pancreatic Enzyme Abnormalities. The aims of the study are to clarify the pathophysiological differences among early chronic pancreatitis (ECP), functional dyspepsia with pancreatic (FD-P) enzyme abnormalities and FD patients and to determine whether camostat mesilate, pancrelipase, and rabeprazole triple therapy improve FD symptoms in the ECP (...) patients was significantly disturbed compared to that in FD patients. The primary outcome of this study is that 4 weeks of camostat mesilate, pancrelipase, and rabeprazole triple therapy significantly ameliorated epigastric pain in ECP patients compared to acotiamide and rabeprazole combination therapy.Although there were no significant differences in pathophysiology between ECP patients and FD-P patients, triple therapy can significantly ameliorate epigastric pain in ECP patients. Further studies

2018 Digestion Controlled trial quality: uncertain

10. Improvement of meal-related symptoms and epigastric pain in patients with functional dyspepsia treated with acotiamide was associated with acylated ghrelin levels in Japan. (PubMed)

Improvement of meal-related symptoms and epigastric pain in patients with functional dyspepsia treated with acotiamide was associated with acylated ghrelin levels in Japan. The aim of this study is to clarify whether acotiamide and rabeprazole combination therapy can improve clinical symptoms, gastric emptying, and satisfaction with treatment in functional dyspepsia (FD) patients more effectively than acotiamide or rabeprazole monotherapy alone. We also aimed to determine whether acotiamide (...) weeks of no treatment. Adenocorticotropic hormone (ACTH), cortisol, leptin and ghrelin levels were measured in all FD patients.Acotiamide and rabeprazole combination therapy significantly improved postprandial distress syndrome (PDS)-like symptoms (p = 0.018, p = 0.04 and p = 0.041, respectively) and epigastric pain (p = 0.024) as wells as STAI-state scores (p = 0.04) compared to rabeprazole monotherapy. Both acotiamide monotherapy, and acotiamide taken in combination with rabeprazole, significantly

2018 Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society Controlled trial quality: uncertain

11. Prospective, Randomized, Controlled Comparison of Local Anesthetic Infusion Pump versus DepoFoam Bupivacaine For Pain Management After Unilateral Delayed Deep Inferior Epigastric Perforator Free Flap Reconstruction. (PubMed)

Prospective, Randomized, Controlled Comparison of Local Anesthetic Infusion Pump versus DepoFoam Bupivacaine For Pain Management After Unilateral Delayed Deep Inferior Epigastric Perforator Free Flap Reconstruction. Effective postsurgical analgesia is a critical aspect of patient recovery. The goal of this prospective, randomized, controlled, blinded study was to examine the effect that liposomal bupivacaine delivered by means of a transversus abdominis plane block has on pain control in women (...) undergoing unilateral deep inferior epigastric perforator flap reconstruction. Institutional review board approval was granted for this prospective study. Patients were eligible if they were undergoing unilateral, delayed deep inferior epigastric perforator flap reconstruction. Patients were randomized to one of three groups: liposomal bupivacaine transversus abdominis plane block, or bupivacaine pain pump. Charts were reviewed for demographics, length of stay, and postoperative narcotic use. There were

2018 Plastic and reconstructive surgery Controlled trial quality: uncertain

12. Diagnosis of gastro-oesophageal reflux disease is enhanced by adding oesophageal histology and excluding epigastric pain. (PubMed)

Diagnosis of gastro-oesophageal reflux disease is enhanced by adding oesophageal histology and excluding epigastric pain. The diagnosis of gastro-oesophageal reflux disease (GERD) in clinical practice is limited by the sensitivity and specificity of symptoms and diagnostic testing.To determine if adding histology as a criterion and excluding patients with epigastric pain enhances the diagnosis for GERD.Patients with frequent upper gastrointestinal symptoms who had not taken a proton pump (...) -based criteria including epithelial hyperplasia was significantly greater when concomitant epigastric pain was absent than when it was present (P < 0.05; NND: 8).Histology increases diagnosis of GERD and should be performed when clinical suspicion is high and endoscopy is negative. Excluding patients with epigastric pain enhances sensitivity for the diagnosis of GERD.© 2017 John Wiley & Sons Ltd.

2017 Alimentary Pharmacology & Therapeutics

13. Increased Frequency of MEFV Genes in Patients with Epigastric Pain Syndrome (PubMed)

Increased Frequency of MEFV Genes in Patients with Epigastric Pain Syndrome Atypical clinical forms of familial Mediterranean fever (FMF) can be misdiagnosed as therapy-resistant epigastric pain syndrome (EPS) for they share many of the same clinical features, such as abdominal pain. Thus, we aimed to determined the frequency of FMF in patients who were followed with a diagnosis of therapy-resistant EPS. Seventy-five patients with therapy-resistant EPS and 20 controls were involved in the study

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2017 Balkan Journal of Medical Genetics : BJMG

14. Epigastric pain syndrome accompanying pancreatic enzyme abnormalities was overlapped with early chronic pancreatitis using endosonography (PubMed)

Epigastric pain syndrome accompanying pancreatic enzyme abnormalities was overlapped with early chronic pancreatitis using endosonography There was not available data about the overlap between functional dyspepsia (FD) and pancreatic diseases. We aimed to determine whether epigastric pain syndrome (EPS) accompanying with pancreatic enzyme abnormalities were associated with early chronic pancreatitis proposed by Japan Pancreas Society (JPS) using endosonography. We enrolled 99 consecutive

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2017 Journal of clinical biochemistry and nutrition

15. Caroli's Disease as a Cause of Chronic Epigastric Abdominal Pain: Two Case Reports and a Brief Review of the Literature (PubMed)

Caroli's Disease as a Cause of Chronic Epigastric Abdominal Pain: Two Case Reports and a Brief Review of the Literature Caroli's disease is a very rare congenital malformation, currently included in cystic diseases of the biliary tract, and is characterized by ectasia and dilatation of the intrahepatic bile ducts. Two clinical entities can be distinguished, Caroli's disease in which congenital hepatic impairment is limited to cystic dilatation and Caroli's syndrome in which congenital hepatic (...) fibrosis coexists. We present two cases of atypical presentations of Caroli's disease. Case one was a 76-year-old man who was referred to our hospital for chronic non-remitting epigastric pain prior to diagnosis. Magnetic resonance cholangiopancreatography (MRCP) was performed, which revealed findings consistent with Caroli's disease. Laboratory investigation disclosed a raised α-fetoprotein. Left hepatectomy was performed due to suspected cholangiocarcinoma. Morphological findings were compatible

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2017 Cureus

16. Peripartum patient with epigastric pain (PubMed)

Peripartum patient with epigastric pain 28844257 2017 12 11 2018 11 13 1097-6760 70 3 2017 Sep Annals of emergency medicine Ann Emerg Med Peripartum Patient With Epigastric Pain. 301-337 S0196-0644(17)30260-3 10.1016/j.annemergmed.2017.03.002 Ryan Davinia D Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY. Cruciata Giuseppe G Department of Radiology, Maimonides Medical Center, Brooklyn, NY. Monti Serena S IRCCS SDN, Naples, Italy. Di Paolo Pier Luigi PL Department (...) of Imaging, Bambino Gesu' Children's Hospital, Rome, Italy. Mannelli Lorenzo L Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY. eng P30 CA008748 CA NCI NIH HHS United States Case Reports Journal Article United States Ann Emerg Med 8002646 0196-0644 AIM IM Abdominal Pain etiology Adult Cesarean Section Female HELLP Syndrome diagnosis Humans Lacerations diagnostic imaging etiology Liver Diseases diagnostic imaging etiology Magnetic Resonance Imaging Pregnancy Pregnancy

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2017 Annals of Emergency Medicine

17. Stent drainage achieved by endoscopic ultrasonography-guided puncture from duodenal bulb to the minor pancreatic duct for the treatment of acute epigastric pain in a patient with pancreas divisum (PubMed)

Stent drainage achieved by endoscopic ultrasonography-guided puncture from duodenal bulb to the minor pancreatic duct for the treatment of acute epigastric pain in a patient with pancreas divisum 28685743 2018 11 13 2303-9027 7 2 2018 Mar-Apr Endoscopic ultrasound Endosc Ultrasound Stent drainage achieved by endoscopic ultrasonography-guided puncture from duodenal bulb to the minor pancreatic duct for the treatment of acute epigastric pain in a patient with pancreas divisum. 130-132 10.4103

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2017 Endoscopic ultrasound

18. Efficacy and safety of manual acupuncture manipulations with different frequencies on epigastric pain syndrome (EPS) in functional dyspepsia (FD) patients: study protocol for a randomized controlled trial. (PubMed)

Efficacy and safety of manual acupuncture manipulations with different frequencies on epigastric pain syndrome (EPS) in functional dyspepsia (FD) patients: study protocol for a randomized controlled trial. Manual acupuncture (MA) manipulations are one of the key factors influencing acupuncture effects in traditional Chinese medicine theory. Different MA manipulations contain different stimulating parameters, thus generating different acupuncture responses or effects. Evidence has demonstrated (...) that acupuncture is effective for functional dyspepsia (FD). However, the effects of different stimulating parameters of MA manipulations on FD remain unclear.This study is a randomized controlled trial with a four-arm, parallel-group structure. Patients with FD with epigastric pain syndrome (EPS) will be included and randomly allocated into four groups: three MA manipulation groups (separately treated with a frequency of 1 Hz, 2 Hz, or 3 Hz) and a control group. All groups will receive omeprazole as a basic

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2017 Trials Controlled trial quality: uncertain

19. Ultrasound-Guided Erector Spinae Plane Block in Patients Undergoing Open Epigastric Hernia Repair: A Prospective Randomized Controlled Study

Ultrasound-Guided Erector Spinae Plane Block in Patients Undergoing Open Epigastric Hernia Repair: A Prospective Randomized Controlled Study Hernia repair is associated with considerable postoperative pain. We studied the analgesic efficacy of bilateral ultrasound-guided erector spinae plane block in patients undergoing open midline epigastric hernia repair (T6-T9).Sixty patients 18-65 years of age were randomly allocated into 2 groups. Patients in the erector spinae plane block group received (...) bilateral ultrasound-guided erector spinae plane block at the level of T7 transverse process using 20 mL of bupivacaine 0.25% on each side, while the control group received bilateral sham erector spinae plane block using 1 mL of normal saline. All patients underwent general anesthesia for surgery. Pain severity (visual analog scale), consumption of intraoperative fentanyl, time to first request of rescue analgesia, and postoperative pethidine consumption were recorded over the first 24 hours

2019 EvidenceUpdates

20. Epigastric Pain in a Patient with Cirrhosis (PubMed)

Epigastric Pain in a Patient with Cirrhosis •Classic images of Schistosomiasis.•Pathology proved case.•Impressive educational case.

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2016 Journal of clinical and experimental hepatology

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