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Showing 4 results for Abdominal Pain
Does analgesia affect the diagnostic process in acute abdomen? a randomized clinical trial
Ravari H, Ghaemi M, Vojdani A, Khashayar P,
Volume 65, Issue 10 (1-2008)
Abstract

Background: About one-forth of the patients admitted to the emergency department complain of acute abdominal pain. According to surgical records, most surgeons believe that pain relief for these patients may interfere with the clinical examinations and the final diagnoses. As a result, analgesics are withheld in patients with acute abdominal pain until the determination of a definite diagnosis and suitable management plan. The purpose of this study was to evaluate the effect of analgesics on the evaluation course and treatment in acute abdomen.

Methods: Two hundred patients at a surgical emergency department with acute abdominal pain were enrolled in this prospective study and randomly divided into two groups at the time of admission. The case group consisted of 98 patients who received intravenous analgesia immediately after admission. The other 102 patients in the control group did not receive analgesia until a definite diagnosis was made. Diagnostic and therapeutic procedures were similar between the two groups. The primary and final diagnoses, and the time intervals between the admission and definite diagnosis, and that between admission and surgery were gathered and analyzed.

Results: The mean time to definitive diagnosis was 1.7 and 2.04 hours in the case and control groups, respectively. There was no statistically significant relationship between analgesic use and gender, age, time to definite diagnosis, or accuracy of the diagnosis. In fact, the time required to achieve a definite diagnosis and the time between admission and surgery were less in the group that had received analgesics.

Conclusions: In spite of the fact that analgesics remove the very symptoms that brings patients to the emergency room, appropriate use of analgesics does not reduce diagnostic efficiency for patients with acute abdominal pain.


The effect of bismuth subcitrate in patients with diarrhea predominant irritable bowel syndrome
Kalani M, Foroutan H, Rahimi R, Ghofrani H, Ahadpoor Behnami Sh,
Volume 68, Issue 6 (9-2010)
Abstract

Background: The irritable bowel syndrome (IBS) is one of the most common chronic medical conditions. Various mechanisms, including altered gut flora and/or small bowel bacterial overgrowth, have been suggested to play a role in the development of gas-related symptoms aim of study. The clinical evidence of small intestinal bacterial overgrowth as an important etiology of irritable bowel syndrome continues to accumulate. Clinical symptoms of bacterial overgrowth and irritable bowel syndrome are similar however, a definitive cause-and-effect relationship remains unproven. It is unclear whether motility dysfunction causes bacterial overgrowth or gas products of
enteric bacteria affect intestinal motility in irritable bowel syndrome.

Methods: In a randomized double-blind placebo-controlled trial consisting of treatment with bismuth subcitrate. Primary efficacy variable was subjective symptoms frequency of abdominal pain, Number of bowel movement & Bloating/distension.

Results: 119 patients were enrolled (59 bismuth subcitrate and 60 placebo recipients). At the end of phase 2, all symptom scores dropped significantly both in bismuth subcitrate and placebo group (p<0.001). There was not a significant difference in symptom relief with bismuth subcitrate versus placebo administration.

Conclusions: There was not a significant difference in symptom relief with bismuth subcitrate versus placebo in IBS patients. Whether antibiotics can improve quality of life in patients with irritable bowel syndrome warrants further research.
Interventions: Participants were randomly assigned to receive 120mg bismuth subcitrate four times daily for 14 days (n=59) or placebo (n=60).


Acute intestinal obstruction due to taenia saginata infestation: a case report
Soleimani A, Soleimani Sr, Hoseini K,
Volume 69, Issue 2 (5-2011)
Abstract
Background: Infection with Taenia saginata or taeniasis is an uncommon parasitic infection in Iran with a prevalence rate of 2-3% and it is more seen in the northern parts of the country. Epigastric pain, nervousness, dizziness, nausea and loss of appetite may be the only presenting symptoms but secondary appendicitis, acute intestinal obstruction and necrosis of the pancreas are its serious and rare complications. Case presentation: A 62-year old woman was admitted to Imam Khomeini Hospital with signs of acute abdomen. She had a past history of infection with hydatid cyst and its subsequent surgery, eight years ago. At the time of admission, she suffered from persistent abdominal pain and loss of appetite for two years. Despite having the epidemiological evidence of working along the banks of rivers contaminated with human sewage and working on farms fertilized with human waste and presence of signs hinting at the disease, parasitic infection had not been considered in its diagnosis. Conclusion: Although signs and symptoms of taeniasis are non-specific but a complete history, physical examination and detailed patient notes, especially by considering epidemiological factors, are very important to the early diagnosis of taeniasis
A case report of ovarian fibroids torsion with ascites and pleural effusion: case report
Seyede Houra Mousavi Vahed , Maliheh Afiat, Fahimeh Alizadeh, Anahita Hamidi Laien , Zeynab Khademi, Azin Nikoozadeh,
Volume 77, Issue 2 (5-2019)
Abstract
Background: Ovarian fibroma is the most common benign solid tumor of the ovary. The most common symptoms are abdominal discomfort and pain. Ovarian fibroids are associated with Meigs syndrome in 1% to 10% of cases. The aim of study is report of a case of Meigs syndrome
Case presentation: A 65-year-old menopausal woman who complained of abdominal pain was referred to our academic hospital of Mashhad, Iran, in April 2018. In abdominal examination, a soft mass with size of 200×100 mm, was detected. Also leukocytosis and increase in CRP was observed. Marker CA125 was higher than 200. In CT scan in right adnexa heterogeneous mass 170×100 mm with enhancement was reveled. pleural effusion was reported in the both lungs and collapse of underlying lung tissue in Chest X-ray. Explorative laparotomy was performed. Ascites and inflamed omentum covered the surface of right ovary was detected. The huge solid-cystic hemorrhagic, irregular mass with a specific pedicle that enclosed in the capsule in right adnexa was seen. Right salpingo-oophorectomy was performed. The result of final pathologic was benign proliferative lesions of mitotic fibroblasts were reported according to ovarian fibroma.
Conclusion: In case of accompanying ovarian mass with ascites and pleural effusion, after the exclude of ovarian malignancies, Meigs syndrome should be considered in differential diagnosis.

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