Missed diagnosis of imperforate hymen later presenting with hypertension

2020 ◽  
Vol 13 (9) ◽  
pp. e237416
Author(s):  
Moira Chia ◽  
Christopher Ho
Keyword(s):  
Abdominal Pain ◽  
Adolescent Girl ◽  
Chronic Abdominal Pain ◽  
Medical Attention ◽  
Imperforate Hymen ◽  
Missed Diagnosis

An adolescent girl presented with hypertension and was found to have haematocolpos and imperforate hymen. She had a background of chronic abdominal pain and had sought medical attention multiple times prior, with the diagnosis being missed as pubertal evaluation and perineal examination had been neglected during those visits. Hypertension resolved following hymenectomy and drainage of haematocolpos with no long-term sequelae.

Chronic Nonspecific Inflammatory Bowel Disease of the Cecum and Proximal Colon in Children With Grossly Normal-Appearing Colonic Mucosa: Diagnosis by Colonoscopic Biopsies

PEDIATRICS ◽  
1987 ◽  
Vol 80 (2) ◽  
pp. 255-261
Author(s):  
Melvin B. Heyman ◽  
Jay A. Perman ◽  
Linda D. Ferrell ◽  
M. Michael Thaler
Keyword(s):  
Inflammatory Bowel Disease ◽  
Abdominal Pain ◽  
Bowel Disease ◽  
Colonic Mucosa ◽  
Disease Process ◽  
Proximal Colon ◽  
Chronic Abdominal Pain ◽  
Medical Attention ◽  
Inflammatory Bowel ◽  
Inflammatory Changes

The diagnosis of inflammatory bowel disease rests on radiologic, endoscopic, and histologic creteria. Five patients, 2 to 17 years of age, sought medical attention because of chronic abdominal pain, diarrhea, and heme-positive stools. Rectal biopsies, visual inspection of colonic mucosa through the colonoscope, and contrast radiographs of the large and small intestine yielded nonspecific results. Serial endoscopic biopsies demonstrated a gradient of inflammatory changes diminishing in severity distally from the ileocecal valve and cecum. The disease process was most evident in specimens from the cecum, whereas biopsies distal to the transverse colon had a normal histologic appearance in all five patients. Biopsies from the proximal colon may provide evidence of inflammatory bowel disease not detectable using standard techniques. The combination of chronic abdominal pain, diarrhea, and heme-positive stools associated with inflammatory changes in biopsy specimens obtained from the proximal colon, but normal findings on radiologic, colonoscopic, and rectal biopsy examinations, may represent an early stage in the evolution of chronic nonspecific inflammatory bowel disease, including ulcerative colitis or regional enteritis (Crohn disease).

scholarly journals Segmental Arterial Mediolysis: An Under-Recognized Cause of Chronic Abdominal Pain

2020 ◽  
Author(s):  
Tulika Chatterjee ◽  
Johnathon Stephens ◽  
Moni Roy
Keyword(s):  
Abdominal Pain ◽  
Medical Management ◽  
Surgical Intervention ◽  
Case Reports ◽  
Healthcare Providers ◽  
Chronic Abdominal Pain ◽  
Segmental Arterial Mediolysis ◽  
The Past ◽  
Missed Diagnosis ◽  
Abdominal Arteries

Segmental arterial mediolysis (SAM) is a non-inflammatory, non-atherosclerotic vasculopathy mostly involving the abdominal arteries. SAM was recently recognized as a more prevalent aetiology of abdominal pain than initially thought by healthcare providers. It is still a commonly missed diagnosis in patients with recurrent emergency room (ER) visits for abdominal pain. Most published case reports in the past have highlighted catastrophic sequelae such as intra-abdominal haemorrhage requiring surgical intervention. We report a case of SAM where the diagnosis was initially missed. After diagnosis, conservative medical management was offered which led to clinical improvement.

scholarly journals Chronic abdominal pain in long-term spinal cord injury: a follow-up study

Spinal Cord ◽  
2016 ◽  
Vol 55 (3) ◽  
pp. 290-293 ◽  
Author(s):  
S D Nielsen ◽  
P M Faaborg ◽  
P Christensen ◽  
K Krogh ◽  
N B Finnerup
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Abdominal Pain ◽  
Chronic Abdominal Pain ◽  
Follow Up Study ◽  
Cord Injury

Acute worsening of chronic abdominal pain and vomiting in an adolescent girl

2017 ◽  
Vol 53 (11) ◽  
pp. 1131-1131
Author(s):  
Samual Marshall ◽  
Christian Abel ◽  
Aniruddh Deshpande
Keyword(s):  
Abdominal Pain ◽  
Adolescent Girl ◽  
Chronic Abdominal Pain

scholarly journals DIAGNOSTIC LAPAROSCOPY IN CHRONIC AND RECURRENT ABDOMINAL PAIN MANAGEMENT

2020 ◽  
Vol 4 (12) ◽  
Author(s):  
Abhishek Jina ◽  
Abhinav Chaudhary ◽  
U C Singh
Keyword(s):  
Abdominal Pain ◽  
Diagnostic Laparoscopy ◽  
Unknown Origin ◽  
Recurrent Abdominal Pain ◽  
Chronic Abdominal Pain ◽  
Chronic Appendicitis ◽  
Fluid Analysis ◽  
Invasive Method ◽  
Safe Technique

Background: Chronic abdominal pain is a common condition encountered by many surgeons in their clinic every day. Despite of availability of different tests in maximum cases the reason behind the pain remains unknown. Diagnostic Laparoscopy is a safe technique that can identify the cause of the pain without using any invasive method. In the present study, the use of diagnostic laparoscopy in the diagnosis and management of chronic and recurrent abdominal pain of unknown origin was investigated. Material and Methods: All the patients who visited the outpatient department with chronic abdominal pain were included in this study. All the demographic parameters were included and after careful investigation diagnostic laparoscopy were conducted in all these patients. The postoperative outcomes were also recorded in all the patients. Result: Total of 51 patients was included in this study. Among these patients 23 patients were male and 28 patients were female. Maximum of the patients were in the 31-40 years of age group. The most common pathology for chronic abdominal pain was chronic appendicitis (n=9, 18%) followed by Koch's abdomen and adhesions (n=8, 16%). There were 4 cases of Carcinoma of the gall bladder and 3 cases of metastatic disease with dissemination in the peritoneal cavity and ascitis. 3 cases of liver cirrhosis and 3 cases of endometriosis were also detected. 2 cases of ovarian cysts which were missed by USG were detected correctly by laparoscopy. There were two unusual cases, one of chronic ectopic pregnancy and another of Crohn's disease. All the above findings were confirmed by direct visualizing (86%), or by biopsy (74%) or by fluid analysis. There were no long term complications in our study. Conclusion: The present study concluded that laparoscopy is a safe and effective method for diagnosis of chronic abdominal pain. Keywords: Chronic abdominal pain, diagnostic laparoscopy, recurrent abdominal pain

Median Arcuate Ligament Syndrome: A Missed Diagnosis in Patients With Chronic Abdominal Pain

2018 ◽  
Vol 113 (Supplement) ◽  
pp. S1050-S1051
Author(s):  
Josh Nichols ◽  
Sarah Al-Obaidi ◽  
Ihsan Al-Bayati ◽  
Irene Sarosiek ◽  
Brian Davis ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Chronic Abdominal Pain ◽  
Median Arcuate Ligament ◽  
Median Arcuate Ligament Syndrome ◽  
Arcuate Ligament ◽  
Missed Diagnosis

Patient with Chronic Abdominal Pain from Pancreatitis

2016 ◽  
Author(s):  
Jianguo Cheng
Keyword(s):  
Abdominal Pain ◽  
Chronic Pancreatitis ◽  
Pain Relief ◽  
Imaging Techniques ◽  
Physical Symptoms ◽  
Chronic Abdominal Pain ◽  
Celiac Plexus ◽  
Comprehensive Treatment ◽  
Gastrointestinal Complications

Early diagnosis of chronic pancreatitis is possible by combining clinical information with pancreatic function testing, endoscopic ultrasonography, histology, and traditional imaging techniques such as magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography (ERCP). Such an approach helps improve the sensitivity and specificity of these complementary modalities. Pain management of chronic pancreatitis involves multidisciplinary and multimodal approaches. Behavioral modifications such as alcohol cessation, nutritional optimization, and cognitive-behavioral therapy play a significant role for better long-term outcomes. Pharmacologic management is directed at relieving both psychological and physical symptoms, and combination pharmacotherapies are often needed to address pancreatic deficiency, abdominal pain, and psychological disorders. Interventional approaches to celiac plexus and splanchnic nerve blocks and denervation (radiofrequency ablation, endoscopic or surgical denervation) may provide significant and prolonged pain relief. Neuromodulation in the form of spinal cord stimulation is a viable option for long-term pain relief. Managing complications of chronic pancreatitis, such as gastrointestinal complications (peptic ulcer, bile duct stenosis), pseudocysts, malnutrition, depression, diabetes, and painful diabetic neuropathy, is an integral part of comprehensive treatment and requires close collaboration between members of a multidisciplinary team.   This review contains 1 figures, 2 tables and 64 references Key words: behavioral modifications, celiac plexus, chronic abdominal pain, chronic pancreatitis, interventional therapy, pharmacologic modulation, splanchnic nerves, surgical intervention

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