Postcholecystectomy pain syndrome: Pathophysiology of abdominal pain in sphincter of Oddi type III

1999 ◽  
Vol 116 (4) ◽  
pp. 900-905 ◽  
Author(s):  
Steven G. Desautels ◽  
Adam Slivka ◽  
William R. Hutson ◽  
Andrew Chun ◽  
Carlos Mitrani ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Pain Syndrome ◽  
Sphincter Of Oddi ◽  
Type Iii ◽  
Postcholecystectomy Pain

scholarly journals Evaluation of the short-term efficacy of local analgesic (lidocaine) and opioid analgesic (sufentanil) on patients with centrally mediated abdominal pain syndrome: a randomized controlled trial

2021 ◽  
Vol 14 ◽  
pp. 175628482110217
Author(s):  
Hang Yang ◽  
Honglin Chen ◽  
Bing Hu
Keyword(s):  
Randomized Controlled Trial ◽  
Abdominal Pain ◽  
Rating Scales ◽  
Rating Scale ◽  
Controlled Trial ◽  
Opioid Analgesic ◽  
Pain Syndrome ◽  
Short Term ◽  
Randomized Controlled ◽  
Term Efficacy

Background: Centrally mediated abdominal pain syndrome (CAPS) is characterized by continuous or frequently recurring abdominal pain and can result in functional loss across several life domains. The efficacy of the present management methods has not been established yet. We performed a prospective randomized controlled trial to explore the short-term efficacy of local analgesic (lidocaine) and opioid analgesic (sufentanil) in patients with CAPS. Methods: We consecutively enrolled 130 patients who met the Rome IV CAPS criteria and divided them into the sufentanil + lidocaine (S + L) group and sufentanil (S) group. Patients completed the pain rating scales, including the numeric rating scale (NRS) and verbal rating scale (VRS), 60 min before colonoscopy. All the patients were initially administered sufentanil. In the S + L group, we sprayed a 5 ml solution of lidocaine on the surface of ascending, transverse, descending, and sigmoid colon during colonoscope withdrawal, while 5 ml saline was sprayed in the S group. Follow up was performed 1 day, 3 days, 1 week, 2 weeks, 1 month, and 3 months after colonoscopy, to complete the pain scaling. Results: A comparison of the NRS and VRS showed that there were no significant differences between the S + L and S groups and within each group ( p > 0.05). Conclusions: Local analgesic lidocaine and opioid analgesic sufentanil showed negative efficacy during short-term observation. The opioid receptor blocker sufentanil did not worsen symptoms in patients with CAPS after colonoscopy under general anesthesia in the short term. [chictr.org.cn, Chinese Clinical Trial Identifier, ChiCTR-IOR-16008187]

scholarly journals Sphincter of Oddi Dysfunction: A Perplexing Presentation

2016 ◽  
Vol 10 (3) ◽  
pp. 714-719 ◽  
Author(s):  
Sana Ahmad Din ◽  
Iman Naimi ◽  
Mirza Beg
Keyword(s):  
Abdominal Pain ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Sphincter Of Oddi ◽  
Abdominal Ultrasound ◽  
Sphincter Of Oddi Dysfunction ◽  
Sphincter Pressure ◽  
Abdominal Symptoms ◽  
Biliary Sphincterotomy ◽  
Bile Drainage ◽  
Oddi Dysfunction

Sphincter of Oddi dysfunction is caused by stenosis or dyskinesia of the sphincter of Oddi, leading to blockage of bile drainage from the common bile duct. We present the case of a 16-year-old female with chronic abdominal pain who underwent laparoscopic cholecystectomy for cholelithiasis but continued to experience abdominal pain, nausea, and vomiting along with persistently elevated ALT and AST levels. Postoperative abdominal ultrasound was nondiagnostic. Esophagogastroduodenoscopy showed mild reflux esophagitis and mild chronic Helicobacter pylori-negative gastritis. Omeprazole was started, but it did not decrease the frequency and severity of the abdominal symptoms. Magnetic resonance cholangiopancreatography did not reveal any pathology. Endoscopic retrograde cholangiopancreatography with manometry confirmed an elevated biliary sphincter pressure. Biliary sphincterotomy was performed, and the symptoms improved.

scholarly journals Pediatric Lymphoma Complicated by Intussusception

2020 ◽  
Vol 13 (4) ◽  
pp. 344-347
Author(s):  
Islam Khuseynovich Shidakov
Keyword(s):  
Small Intestine ◽  
Abdominal Pain ◽  
Pain Syndrome ◽  
Intestinal Lumen ◽  
Older Children ◽  
Intestinal Lymphoma ◽  
Intestinal Intussusception ◽  
Pain Attack ◽  
Repeated Pain ◽  
Oncological Center

Intestinal intussusception is rare in children over the age of 6 years and, in most cases, is due to the presence of anatomical reasons. Tumors of the gastrointestinal tract are one of the etiological factors in the development of ileus in older children. The paper presents the case of a 7-year-old child who was admitted to the clinic with the abdominal pain syndrome that resolved on its own. With a repeated pain attack, intestinal intussusception was diagnosed, the patient was urgently operated. Laparoscopic complete reduction of intussusception failed, which required conversion of the access. After straightening the intussusception of the small intestine, there was detected a tumor of the ileum, which practically blocked the intestinal lumen. The segment of the intestine with the tumor was resected with an end-to-end anastomosis. In the postoperative period, the patient was diagnosed with intestinal lymphoma based on the test studies of the operating material. After stabilizing the condition, the child was transferred to an oncological center.

scholarly journals Pelvic inflammatory disease by actinomyces: report of 1 case and review of the literature

2020 ◽  
Vol 9 (2) ◽  
pp. 804
Author(s):  
Cesar Giovanni Camacho Herrera ◽  
Raul D. Lara Sanchez ◽  
Narmy Olivera Garcia ◽  
Karla E. Abundiz Bibiano
Keyword(s):  
Abdominal Pain ◽  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
Intrauterine Device ◽  
Fibrous Tissue ◽  
Pain Syndrome ◽  
Exploratory Laparotomy ◽  
Abdominal Hysterectomy ◽  
Histopathological Diagnosis ◽  
Persistent Abdominal Pain

Actinomycosis is a chronic disease that is characterized by the formation of abscesses, fistulas and dense fibrous tissue at the site of involvement. Its distribution is worldwide. However, pelvic actinomycosis has increased in frequency and has been associated with abdominal surgery, intestinal perforation or trauma, due to the destruction of the muscular barrier. The clinical elements of suspicion are the latency of months and even years of symptoms and the history of being a carrier of an intrauterine device. Actinomyces israelli is a rare etiological agent of pelvic inflammatory disease, so it is difficult to reach the diagnosis. A case report is made of a 48-year-old patient with an intrauterine device older than 5 years, who entered the emergency department with abdominal pain syndrome and 7-day evolutionary fever accompanied by dyspareunia. She was hospitalized for antibiotic treatment, presenting an unsatisfactory evolution, with increased leukocytosis and persistent abdominal pain. An exploratory laparotomy with abdominal hysterectomy was performed. The histopathological diagnosis was pelvic inflammatory disease due to actinomyces. We must always suspect in the presence of a pelvic inflammatory disease in any of its clinical forms, the presence of actinomyces as one of the possible causative germs, especially in patients with intrauterine device for more than 5 years.

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