Case 8: Abdominal pain and weight loss

Keyword(s):  
2021 ◽  
Vol 14 ◽  
pp. 117954762110177
Author(s):  
Rebecca DeBoer ◽  
Sahani Jayatilaka ◽  
Anthony Donato

Whipple’s disease (WD) is an uncommon cause of seronegative arthritis. WD is known for its gastrointestinal symptoms of diarrhea, weight loss, and abdominal pain. However, arthritis may precede gastrointestinal symptoms by 6 to 7 years. We describe a case of an 85-year-old Caucasian male with multiple joint complaints, not responsive to traditional treatments for conditions such as rheumatoid arthritis and osteoarthritis. We suggest that WD be considered for seronegative arthritis especially affecting large joints.


2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Miral Subhani ◽  
Kaleem Rizvon ◽  
Paul Mustacchia

Obesity is an epidemic in our society, and rates continue to rise, along with comorbid conditions associated with obesity. Unfortunately, obesity remains refractory to behavioral and drug therapy but has shown response to bariatric surgery. Not only can long-term weight loss be achieved, but a majority of patients have also shown improvement of the comorbid conditions associated with obesity. A rise in the use of surgical therapy for management of obesity presents a challenge with an increased number of patients with problems after bariatric surgery. It is important to be familiar with symptoms following bariatric surgery, such as nausea/vomiting, abdominal pain, dysphagia, and upper gastrointestinal bleeding and to utilize appropriate available tests for upper gastrointestinal tract pathology in the postoperative period.


2021 ◽  
Vol 385 (25) ◽  
pp. 2378-2388
Author(s):  
Lisa L. Willett ◽  
Gabrielle K. Bromberg ◽  
Ryan Chung ◽  
Rebecca K. Leaf ◽  
Rose H. Goldman ◽  
...  

2005 ◽  
Vol 129 (7) ◽  
pp. 947-949
Author(s):  
Victoria Alagiozian-Angelova ◽  
Lawrence Jennings ◽  
Jigna Jani ◽  
Elliot Weisenberg

2018 ◽  
Vol 150 (10) ◽  
pp. e33 ◽  
Author(s):  
Ana Latorre Díez ◽  
Juan J. González Soler ◽  
Beatriz Suárez Rodríguez

2018 ◽  
pp. 387-398
Author(s):  
Abdullah Jibawi ◽  
Mohamed Baguneid ◽  
Arnab Bhowmick

Pancreatic cancer is the tenth most common cancer in the UK and is most often incurable at diagnosis. Presentation is generally with weight loss, jaundice, and or abdominal pain. Abdominal ultrasound, CT and MRI may be diagnostic. Tissue diagnosis is not usually necessary, but endoscopic ultrasound can obtain fine needle samples. The serum marker CA19-9 may be raised, but is not a screening test. Potentially curable lesions need careful multidisciplinary assessment for resectability, and a thorough assessment of patient fitness. The Whipple procedure is discussed as well as laparoscopic pancreatectomy. Adjuvant chemotherapy and palliative gemcitabine therapy are also covered.


2008 ◽  
Vol 74 (7) ◽  
pp. 602-606 ◽  
Author(s):  
Stephen H. Gray ◽  
Mary T. Hawn ◽  
Meredith L. Kilgore ◽  
Huifeng Yun ◽  
John D. Christein

Early diagnosis and curative resection are significant predictors of survival in patients with pancreatic cancer. We hypothesize that cholecystectomy within 12 months of pancreatic cancer affects 1-year survival. The Surveillance Epidemiology and End Result (SEER) database linked to Medicare data was used to identify patients diagnosed with pancreatic cancer who underwent cholecystectomy 1 to 12 months prior to cancer diagnosis. The SEER database identified 32,569 patients from 1995 to 2002; 415 (1.3%) underwent cholecystectomy prior to cancer diagnosis. Patients who underwent cholecystectomy had a higher proportion of diabetes (40.2% vs 20.5%; P < 0.01), obesity (8.9% vs 3.1%; P < 0.01), jaundice (17.3% vs 0.7%; P < 0.01), cholelithiasis (70.4% vs 4.2%; P < 0.01), choledocholithiasis (0.7% vs 0.0%; P < 0.01), weight loss (17.3% vs 4.7%; P < 0.01), abdominal pain (79.5% vs 22.5%), steatorrhea (0.7% vs 0.0%; P < 0.01), and cholecystitis (32.3% vs 1.7%; P < 0.0001). After controlling for tumor stage, patient demographics, and symptoms, survival at 1 year was significantly lower in patients undergoing cholecystectomy (OR, 0.75; 95% CI, 0.58–0.97). Recent cholecystectomy is associated with decreased 1-year survival among patients with pancreatic cancer. For patients older than 65 years of age, further evaluation prior to cholecystectomy may be necessary to exclude pancreatic cancer, especially patients with jaundice, weight loss, and steatorrhea.


2011 ◽  
Vol 12 (1) ◽  
pp. 81-85
Author(s):  
Mohammad Robed Amin ◽  
Farzana Shumi ◽  
Hasibuddin Khan ◽  
Syed Ahmed Abdullah ◽  
Shafiul Alam ◽  
...  

An elderly patient presented with prolonged fever, gross weight loss, recurrent haemoptysis and abdominal pain. He had a background history of adrenal tuberculosis with completion of treatment without any obvious improvement. Clinically he was diagnosed as a case of adrenocotical insufficiency. Evaluation including histopathology revealed the diagnosis as disseminated histoplasmosis involving adrenal gland and lungs. The disease is a rarity without any underneath immunosuppression and hence high index of suspicion with appropriate steps for investigation is the key to achieve a diagnosis of disseminated histoplasmosis in Bangladesh. Keyword: . DOI: 10.3329/jom.v12i1.6936J Medicine 2011; 12 : 81-85


CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S24-S24
Author(s):  
D. Foster ◽  
K. Van Aarsen ◽  
J. Yan ◽  
J. Teefy ◽  
T. Lynch

Introduction: Cannabinoid Hyperemesis Syndrome (CHS) in pediatric patients is poorly characterized. Literature is scarce, making identification and treatment challenging. This study's objective was to describe demographics and visit data of pediatric patients presenting to the emergency department (ED) with suspected CHS, in order to improve understanding of the disorder. Methods: A retrospective chart review was conducted of pediatric patients (12-17 years) with suspected CHS presenting to one of two tertiary-care EDs; one pediatric and one pediatric/adult (combined annual pediatric census 40,550) between April 2014-March 2019. Charts were selected based on discharge diagnosis of abdominal pain or nausea/vomiting with positive cannabis urine screen, or discharge diagnosis of cannabis use, using ICD-10 codes. Patients with confirmed or likely diagnosis of CHS were identified and data including demographics, clinical history, and ED investigations/treatments were recorded by a trained research assistant. Results: 242 patients met criteria for review. 39 were identified as having a confirmed or likely diagnosis of CHS (mean age 16.2, SD 0.85 years with 64% female). 87% were triaged as either CTAS-2 or CTAS-3. 80% of patients had cannabis use frequency/duration documented. Of these, 89% reported at least daily use, the mean consumption was 1.30g/day (SD 1.13g/day), and all reported ≥6 months of heavy use. 69% of patients had at least one psychiatric comorbidity. When presenting to the ED, all had vomiting, 81% had nausea, 81% had abdominal pain, and 30% reported weight loss. Investigations done included venous blood gas (30%), pregnancy test in females (84%), liver enzymes (57%), pelvic or abdominal ultrasound (19%), abdominal X-ray (19%), and CT head (5%). 89% of patients received treatment in the ED with 81% receiving anti-emetics, 68% receiving intravenous (IV) fluids, and 22% receiving analgesics. Normal saline was the most used IV fluid (80%) and ondansetron was the most used anti-emetic (90%). Cannabis was suspected to account for symptoms in 74%, with 31% of these given the formal diagnosis of CHS. 62% of patients had another visit to the ED within 30 days (prior to or post sentinel visit), 59% of these for similar symptoms. Conclusion: This study of pediatric CHS reveals unique findings including a preponderance of female patients, a majority that consume cannabis daily, and weight loss reported in nearly one third. Many received extensive workups and most had multiple clustered visits to the ED.


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