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Abdominal Pain in the Elderly

Ji Li, Yabin Zou, Bin Wang, Xiangwei Meng, Xun Sun
RATIONALE: Primary renal lymphoma (PRL) is a rare malignancy due to the absence of lymphatic tissues in the kidney, and patients with PRL have been reported to have a poor prognosis due to its rapid invasiveness and limited treatment strategies. Colon cancer is the third most common cancer, and has a high mortality rate. Both malignant diseases predominantly affected elderly men; however, a case with concomitant occurrence of the 2 cancers is extremely rare. PATIENT CONCERNS: A 78-year-old male patient with abdominal pain came to our hospital...
March 2019: Medicine (Baltimore)
Vincenzo Davide Palumbo, Benedetto Di Trapani, Antonio Bruno, Mario Feo, Bernardo Molinelli, Simone Tomasini, Attilio Ignazio Lo Monte, Marianna Messina, Giovanni Tomasello
INTRODUCTION: Hepatic abscess can be defined as an encapsulated collection of suppurative material within the liver parenchyma. Hepatic abscess can be distinguished as pyogenic, amebic, or fungal. Biliary tract disease remains the most common cause of hepatic abscess today, and the most common complications range from pleural effusion, empyema, and bronchohepatic fistula to subphrenic abscess and rupture into the peritoneal cavity, stomach, colon, vena cava, or kidney. A large abscess compressing the inferior vena cava and the hepatic veins may result in Budd-Chiari syndrome...
February 25, 2019: Journal of Medical Case Reports
A Giannini, M Caretto, E Russo, P Mannella, T Simoncini
Pelvic floor dysfunctions are a complex condition in elderly women; pelvic organ prolapse, urinary or fecal incontinence, constipation, pelvic pain, and sexual dysfunction are common problems. The goal of surgical treatment is functional reconstruction with symptom management and repair of anatomic defects. The recent advancements in surgical treatment of pelvic floor dysfunction allow several good options for choosing the best surgery for each patient. The vaginal procedure is traditionally the gold standard approach for elderly patients, but abdominal surgery is increasing as a mini-invasive approach and the robotic approach is gaining acceptance for treatment of pelvic floor dysfunctions...
February 2019: Climacteric: the Journal of the International Menopause Society
Brielle Elizabeth Wood, Jodie Trautman, Nicholas Smith, Soni Putnis
Acalculous cholecystitis caused by gallbladder torsion is a rare condition. Only 500 cases have been reported since the first diagnosed case in 1898. We present the case of a 89-year-old woman with sudden onset of severe epigastric pain, radiating across her right costal margin, associated with nausea. Her abdomen was soft, mildly distended, Murphy's negative but with epigastric tenderness and palpable mass. Computed tomography and ultrasound demonstrated significant acute cholecystitis, with the common bile duct measuring 7 mm...
2019: SAGE Open Medical Case Reports
Jin Liu, Yao Wang, Haiping Jiang, Xiongfei Yu, Nong Xu
RATIONALE: Colorectal cancer (CRC) is one of the most common cancers all over the world, and approximately 70% of the newly diagnosed patients are over 65 years old. Due to the aging of society, there will be more and more elderly patients of CRC in the future. Treatment of CRC in elderly patients is much more challenging thanks to multiple factors including disabling comorbidities as well as declines in organs function, especially in advanced or metastatic settings. PATIENT CONCERNS: An 82-year-old female without history of disease was admitted to the emergency room because of abdominal pain in December 2009...
February 2019: Medicine (Baltimore)
Tetsuro Isozaki, Kentaro Tasaki, Masayuki Kimura, Toru Fukunaga, Yuji Sugamoto, Mari Kuboshima, Yo Asai, Tetsutaro Sazuka, Yosuke Watanabe, Ryuma Urahama, Toshiki Kamata, Hisahiro Matsubara
An 87-year-oldwoman was admittedto our hospital with abdominal pain andfever. Computedtomography showeda 25 mm tumor mass in the pancreatic headandshowedd ilatation of the pancreatic duct andcommon bile duct. She was diagnosed with obstructive cholangitis due to pancreatic head cancer. An endoscopic naso-biliary drainage(EUS)tube was inserted, and an endoscopic ultrasound(ENBD)examination was performed. At this time, duodenal perforation occurred, and an emergency operation was performed. During the laparotomy, perforation was found in the anterior wall of the duodenum...
December 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Christophe L Bertin, Simon Ponthus, Hari Vivekanantham, Pierre-Alexandre Poletti, Omar Kherad, Olivier T Rutschmann
BACKGROUND: Plain abdominal radiography (PAR) is routinely performed in emergency departments (EDs). This study aimed to (1) identify the indications for PAR in EDs and compare them against international guidelines, (2) uncover predictors of non-compliance with guidelines, and (3) describe the use of additional radiological examinations in EDs. METHODS: Retrospective cohort study in the EDs of two hospitals in Geneva, Switzerland, including all adult patients who underwent PAR in the EDs...
January 14, 2019: BMC Health Services Research
Marcello Covino, Carmine Petruzziello, Graziano Onder, Alessio Migneco, Benedetta Simeoni, Francesco Franceschi, Veronica Ojetti
OBJECTIVES: Globally, the average age of the population is increasing. Patients aged >65 years attending hospital emergency departments (EDs) differ from younger patients; in particular, they often present with multiple comorbidities. Our retrospective study evaluates the number of attendances at our ED by elderly patients in the 12 years from January 2005 to December 2017. Our first aim was to evaluate differences presented by elderly patients regarding symptoms, clinical features, color code (i...
February 2019: Maturitas
Yun-Zhi Shen, Xiao-Hui Peng, Yu Bai, Bin Xiong, Ping Che, De-Quan Jiang
OBJECTIVE: We conducted this study to investigate the clinical efficacy of endoscopic retrograde cholangiopancreatography (ERCP) on elder choledocholithiasis and its effects on the levels of TNF-α, IL-1, and IL-6. METHODS: Elder patients with choledocholithiasis were enrolled in this study, and according to the surgical methods, they were divided into the ERCP group and the surgical group. After treatment, we compared the efficacy of these two methods on patients, inflammatory responses indicated by the levels of TNF-α, IL-1, and IL-6, and the complications...
November 2018: Revista da Associação Médica Brasileira
Christopher G Gartin, Jared Reyes, Stephen D Helmer, James M Haan
BACKGROUND: This study aimed to determine the incidence of intra-abdominal injuries in elderly patients after a ground-level fall. METHODS: A 6-year retrospective review was conducted on patients 65 years of age or older involved in a fall from standing and evaluated at a level 1 trauma center. Each patient presented with a pelvic, thoracolumbar, and/or lower rib fracture. Data collection included demographics, injury characteristics, FAST exam results, CT imaging results, and hospitalization outcomes...
December 8, 2018: American Journal of Surgery
R F Cherevatenko
AIM: To analyze analgesic efficacy of aertal in combination with manual therapy. MATERIAL AND METHODS: There were 120 patients with low back pain aged 18 - 78 years. In 21 patients, the cause of pain was a discoradicular conflict, in 99 patients - non-specific. In case of acute pain duration of treatment ranged from 5 to 24 days, in subacute and chronic pain - 3-14 and 7-30 days, respectively. There were no adverse events during treatment in 110 out of 120 patients, 10 patients complained of abdominal discomfort...
2018: Khirurgiia
Kannan Periasamy, Nikhila Radhakrishna, Ashutosh Mukherji, Rajesh Nachiappa Ganesh
Background: Primary gastric adenocarcinoma commonly occurs in the elderly in the sixth to seventh decade of life but is exceedingly rare in children and adolescents, accounting for only 0.05% of pediatric gastrointestinal malignancies. Because of the nonspecific clinical presentation, gastric adenocarcinomas in children and adolescents are often metastatic when they are discovered. Case Report: We describe a case of gastric adenocarcinoma in a 16-year-old female who was diagnosed early and successfully treated with surgery and chemoradiation by volumetric modulated arc technique...
2018: Ochsner Journal
Chen-Hui Ni, Huan Li, Chuan-Bao Xia, Yang-Tian Chen
RATIONALE: The case of parasternal diaphragmatic hernia is relatively rare in adults. The best way for the treatment of diaphragmatic hernia is to receive operation, yet which surgical method is the best remains unclear. PATIENT CONCERNS: An elderly woman in the hospital was complaining about upper abdominal pain that was complicated by the parasternal diaphragmatic hernia. Such state was found accidentally in a car accident and diagnosed by a computed tomography (CT) scan...
December 2018: Medicine (Baltimore)
Muhammad Usman Tariq, Zubair Ahmad, Jamshid Abdul-Ghafar, Nasir Ud Din
Background: Serous cystadenomas of pancreas are rare benign epithelial neoplasms, which predominantly occur in the pancreatic body and tail of elderly females. Majority of these tumors have microcystic appearance. Macrocystic and solid variants have also been described. A number of more aggressive cystic pancreatic lesions are included in the differential diagnosis. Distinction from such lesions is important for optimal management. Objective: Our aim was to study the clinical and histological features of serous cystadenomas which would be helpful in making their correct diagnosis and understanding their behavior...
2018: Rare Tumors
C Sousa-Ribeiro, L N C Tavore, L Anjos-Ramos
Strongyloidiasis is an intestinal parasitosis that occurs in humans infected by Strongyloides stercoralis mostly. At its acute phase, symptoms like constipation, diarrhea and abdominal pain can be observed, but become asymptomatic for a long time, until an immunosuppression will start a hyperinfection and the dissemination of the disease, prevalent on the elderly population in tropical countries. Ivermectina treatment is the currently choice for this disease, due to its great efficacy and the results reported...
December 6, 2018: Acta Tropica
Albane de Thézy, Marie Simon, Pauline Jouët, Tristan Cudennec
There are numerous indications for gastrointestinal endoscopies in elderly people. These include notably bleeding of the digestive tract, unexplained anorexia, abdominal pain, a pathology of the colon or screening for cancerous lesions. These examinations are carried out by a multidisciplinary team. It is essential that the patient is informed as a certain amount of prior preparation is required to ensure the good quality of the examinations.
July 2018: Soins. Gérontologie
Manish P Shrestha, Sasha Taleban
The incidence rate of ulcerative colitis (UC) in older patients is rising. Diagnosis of UC may be difficult in older patients as several common gastrointestinal disorders can mimic UC in these patients. Compared with younger adults, left-sided colitis is more common in older-onset UC, while rectal bleeding, abdominal pain, and extraintestinal manifestations are less common. The disease course of older-onset UC may be similar to that of adult-onset UC. The management of UC in older patients includes medical and surgical options...
January 2019: Drugs & Aging
Jaime A Cardona-Ospina, Carlos E Jiménez-Canizales, Heriberto Vásquez-Serna, Jesús Alberto Garzón-Ramírez, José Fair Alarcón-Robayo, Juan Alexander Cerón-Pineda, Alfonso J Rodríguez-Morales
The febrile patient from tropical areas, in which emerging arboviruses are endemic, represents a diagnostic challenge, and potential co-infections with other pathogens (i.e., bacteria or parasites) are usually overlooked. We present a case of an elderly woman diagnosed with dengue, chikungunya and Leptospira interrogans co-infection. Study Design: Case report. An 87-year old woman from Colombia complained of upper abdominal pain, arthralgia, myalgia, hyporexia, malaise and intermittent fever accompanied with progressive jaundice...
November 26, 2018: Tropical medicine and infectious disease
Paolo Ruscelli, Claudio Renzi, Andrea Polistena, Alessandro Sanguinetti, Nicola Avenia, Georgi Popivanov, Roberto Cirocchi, Massimo Lancia, Sara Gioia, Renata Tabola
RATIONALE: Retroperitoneal colonic perforation is a rare cause of retroperitoneal abscess. It presents, more frequently in frail elderly patients, with heterogeneous signs and symptoms which hamper the clinical diagnosis. Subcutaneous emphysema with pneumomediastinum and iliopsoas muscle abscess are unusual signs. Colonic retroperitoneal perforation may be consequent to diverticulitis or locally advanced colon cancer. Due to the anatomy of the retroperitoneal space and different physiopathology, diverticular perforation may present with air and pus collection; on the other hand perforated colon cancer may cause groin mass and psoas abscess...
November 2018: Medicine (Baltimore)
Hasan Calis
OBJECTIVE: To assess the factors affecting the morbidity and mortality in patients over 65 years of age who underwent appendectomy. STUDY DESIGN: An observational study. PLACE AND DURATION OF STUDY: Department of General Surgery, Faculty of Medicine, Ahi Evran University, Kirsehir, Turkey, from November 2014 to March 2017. METHODOLOGY: Medical records of the patients over 65 years of age with the diagnosis of acute appendicitis who underwent appendectomy during the study period were retrospectively analyzed...
November 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
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