Cases reported "Colic"

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1/23. Three common presentations of ascariasis infection in an urban Emergency Department.

    In the united states, approximately 4 million people per year are infected with ascaris lumbricoides. We reviewed the common presentations of complications of ascariasis infection in the Emergency Department (ED) and the diagnostic tools and treatment available. This was a retrospective case review conducted on all patients diagnosed with ascariasis (using ICD-9 codes) over a 6-year period at los angeles County and University of Southern california Medical Center. Three patients with distinct complications secondary to ascariasis were chosen, and all ED and inpatient records were reviewed. The patient's age, sex, race, presenting symptoms, data, outcome, and ED course and diagnosis were recorded. The three cases included a periappendiceal abscess, Loeffler's syndrome, and biliary colic/choledocholithiasis. The first patient underwent a computed tomography-guided drainage of the abscess. The second patient received supportive care and antibiotic therapy secondary to a superimposed bacterial pneumonia. The third patient underwent endoscopic retrograde cholangiopancreatography with sphincterotomy. All three patients had a stool ova and parasites positive for A. lumbricoides, and all received a 3-day course of mebendazole. Symptomatic cases of ascariasis may present to EDs in the united states. Important diagnostic tools for the ED include chest X-ray, X-ray of the kidney-ureter-bladder and ultrasonography. Single-dose medications given in the ED are very effective in eradicating A. lumbricoides infection, thus avoiding hospitalization.
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ranking = 1
keywords = chest
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2/23. Relief by naloxone of morphine-induced spasm of the sphincter of oddi in a post-cholecystectomy patient.

    spasm of the sphincter of oddi is a well-recognized effect of the narcotic class of drugs. Although it is usually clinically silent, such spasm occasionally causes debilitating pain that may be mistaken for more serious disorders. We present the case of a patient who had undergone cholecystectomy previously, but in whom morphine given in the Emergency Department precipitated pain consistent with biliary colic; the pain resolved promptly after administration of naloxone. This entity may considered in the differential diagnosis of acute onset of colicky abdominal pain in the patient given narcotics.
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ranking = 438.36157405377
keywords = abdominal pain
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3/23. Toothpick injury mimicking renal colic: case report and systematic review.

    We describe a case of a patient with left flank pain that was caused by a perforation in the splenic flexure of the colon by a toothpick. We conducted a systematic review of the literature to examine the nature of injuries caused by ingested toothpicks. Articles were analyzed for the following outcome variables: presenting complaint, site of injury, recollection of toothpick ingestion, time to presentation, findings from imaging studies, and mortality. Most patients (70%) presented with abdominal pain. Few patients (12%) remember swallowing a toothpick. The onset of symptoms ranged from <1 day to 15 years. Toothpicks caused perforation most frequently at the duodenum and the sigmoid. In some cases, toothpicks migrated outside the gastrointestinal tract and were found in the pleura, pericardium, ureter, or bladder. Toothpicks were apparent on imaging studies in 14% of the cases. The definitive diagnosis was most commonly made at laparotomy (53%), followed by endoscopy (19%). overall mortality was 18%. Ingested toothpicks may cause significant gastrointestinal injuries, and must be treated with caution.
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ranking = 438.36157405377
keywords = abdominal pain
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4/23. Appendiceal colic: A rare complication of colonoscopy.

    We report a case of appendiceal colic presenting as chronic right lower quadrant abdominal pain, without leukocytosis or other inflammatory signs, following an uneventful colonoscopic exam without biopsy or polypectomy. The resected appendix appeared grossly abnormal and was engorged with fecal material. The patient was immediately relieved of pain and remains so four years postoperatively. We conclude that insufflation of the cecum caused inspissation of fecal material into the lumen of the appendix. The ensuing incomplete or partial obstruction of the appendiceal lumen resulted in development of appendiceal colic without any signs or symptoms of inflammation.
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ranking = 438.36157405377
keywords = abdominal pain
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5/23. Symptomatic cholecystolithiasis after laparoscopic cholecystectomy.

    A 45-year-old woman was admitted to our hospital complaining of upper abdominal pain. Seven months earlier a laparoscopic cholecystectomy had been carried out and a solitary gallstone removed together with the gallbladder. The patient now suffered from pain of the same character but lower intensity compared to the situation before the operation. At admission there were no abnormal laboratory findings, especially no signs of infection or cholestasis. Ultrasound revealed a stone in a gallbladder-like structure in the right epigastric region. ERCP revealed an inconspicuous cystic duct stump and no pathological findings in the extra- and intrahepatic bile ducts. MRCP and CT showed a cyst-like structure in the gallbladder region containing a concrement. The patient was transferred to the Department of Surgery for exploratory laparotomy, and a residual gallbladder with an infundibular gallstone was removed. The recurrent upper abdominal pain was obviously caused by a gallstone redeveloped after incomplete laparoscopic gallbladder resection. Retrospectively it could not be discerned whether a doubled or a septated gallbladder was the reason for the initial incomplete resection.
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ranking = 889.91117165914
keywords = abdominal pain, upper
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6/23. Management of gestational nephrolithiasis in the presence of a bicornuate uterus and pelvic kidney.

    A 39-year-old para 0( 1) woman with known nephrolithiasis within a left-sided pelvic kidney presented with left-sided renal colic at 7 weeks gestation. She had a previous miscarriage due to a bicornuate uterus. Ultrasound and magnetic resonance urography confirmed an incomplete obstruction of the left upper renal tract which was relieved by percutaneous nephrostomy. She presented again at 14 weeks with renal colic and minimal output. An ultrasound confirmed recurrent hydronephrosis and a nephrostogram showed that the catheter had retracted almost completely from the collecting system. This was considered to be due to the upward pressure of the enlarging uterus on the catheter, which had been fixed externally to the skin. This problem was obviated by not securing the replacement nephrostomy tube to the skin. She developed pre-eclamptic toxaemia and gave birth at 35 weeks gestation by caesarean section. The calculus was later dissolved using extra-corporeal shockwave lithotripsy.
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ranking = 6.5940117757993
keywords = upper
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7/23. renal colic during sexual intercourse: a unique presentation.

    The average lifetime risk of renal stones has been reported to be in the range of 5-21%, and the majority of patients have recurrent stones (Tiselius et al. in Eur Urol 40:362-371, 2001). The peak incidence is between the fourth and fifth decades, and therefore generally active and working adults are most affected. Stones are usually formed in a calyx, and become symptomatic if they move to obstruct the upper urinary tract. In the majority of cases, there is no specific action which causes stone movement from a non-obstructing to an obstructing position. We present the first ever case report in the literature of an episode of renal colic during sexual intercourse. The role of percussion therapy and postural drainage are well established following shockwave lithotripsy (SWL) to enhance passage of lower pole stone fragments (Brownlee et al. in J Urol 143:1096, 1990), and it may well be the result of similar principles of motion and body positioning which caused the patient to present in this manner.
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ranking = 6.5940117757993
keywords = upper
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8/23. Variant angina induced by biliary colic.

    A 65 year old woman with gall stones presented with crushing chest pain after an attack of biliary colic. The electrocardiogram showed ST segment elevation in leads I, aVL, and V1-V3 while leads II, III, and aVF showed ST segment depression. Cardiac enzyme activity remained within the normal range. During the next three weeks attacks of epigastric and right hypochondrial pain preceded by crushing chest pain with identical electrocardiogram changes occurred with decreasing frequency. Coronary arteriography showed 60% obstruction of the left anterior descending coronary artery and good left ventricular function. During the next three years the patient complained both of mild abdominal pain, probably biliary colic, and mild effort related angina pectoris without a relation between the two symptoms. It is suggested that the attack of variant angina was triggered by biliary colic through sympathoadrenal discharge causing vasospasm.
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ranking = 440.36157405377
keywords = abdominal pain, chest
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9/23. abdominal pain as a first symptom of iliac vein thrombosis.

    Two patients are described with abdominal pain as a first symptom of primary iliac vein thrombosis. This phenomenon can be regarded to be analogous to the calf tenderness when thrombosis arises from the venous sinusoids in the calf muscles which is the usual localisation. When one is aware of this clinical entity, thrombotic occlusion will be recognized as the cause of the complaints, instead of being regarded to be a complication of another, yet unknown disease.
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ranking = 438.36157405377
keywords = abdominal pain
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10/23. cholesteatoma of the upper urinary tract.

    cholesteatoma of the urinary tract is a rare condition which can be diagnosed radiographically. The radiographic findings of stringy intraluminal defects or nodules that may lightly calcify or coalesce to form a discrete mass in association with calculi and/or obstruction are characteristic. A history of chronic urinary tract infection, renal colic, and desquamated epithelial cells in the urine further support the diagnosis.
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ranking = 26.376047103197
keywords = upper
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