Cause Of Abdominal Distension Research Articles

Clinical and biochemical characteristics of glycogen storage disease in Bangladeshi children from a tertiary care center

Abstract Background: Glycogen storage diseases (GSDs) are a group of metabolic diseases that results in aberrant glycogen metabolism due to genetic abnormalities of various enzymes. Glycogen degradation disorders primarily affect the liver, muscles, or both, which are the most seriously affected organs. Aim: This study aimed to determine the clinical and biochemical characteristics of GSD in children at Pediatric Gastroenterology and Nutrition Department, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. Materials and Methods: This cross-sectional study was conducted over a period of 1 year and 6 months from October 2021 to March 2023. All children diagnosed with GSD on liver biopsy were enrolled in the study. Results: Among 437 children, 21 (4.8%) had a clinical diagnosis of GSD. The mean age at presentation to BSMMU was 2.3 ± 1.3 years. The male-to-female ratio was 1:1.1. Hepatomegaly was the primary cause of abdominal distension in all 21 patients (100%), whereas splenomegaly was found in nine (41.8%) patients. No patient had exhibited jaundice. One patient (4.7%) had experienced delayed development. The levels of serum glutamic-pyruvic transaminase and uric acid were both increased in 16 (76.1%) and 20 (95.2%) patients, respectively. Around 4.7% of cases had neutropenia, hypoglycemia, and nephromegaly. Eighteen (85.7%) patients had short stature. Cirrhotic changes were absent in liver biopsy though periportal fibrosis was detected in 4 (19%) of the individuals. Conclusions: Children with GSD commonly present with short stature, hypertriglyceridemia, and hyperuricemia. Histopathology of the liver remains the preferred diagnostic means in Bangladesh.

Abdominal Swelling and Distension: An Unusual Cause of ‘Ascites’

Cases of abdominal bloating and distension are frequently seen in acute and emergency medicine. Although ascites remain a common cause, other differentials such as bladder distension, intestinal obstruction or masses, fecal loading, gynecological tumors and rarely, pregnancy in women of childbearing age group, must be considered. In this article we illustrate an unusual cause of abdominal distension.

Clinical features and etiology of abdominal distension in children

To study the clinical features and etiology of abdominal distension in children with different ages. A retrospective analysis was performed for the clinical data of 1 561 children who were admitted due to abdominal distension from January 2013 to October 2016, including clinical manifestations, radiological examination, pathological results, and disease diagnosis. Among the 1 561 children, there were 823 neonates (aged <28 days), 307 infants (aged 28 days to 1 year), 186 toddlers (aged 1-3 years), 120 preschool children (aged 3-6 years), 106 school-aged children (aged 6-12 years), and 19 adolescents (aged 12-17 years). Vomiting was the major associated symptom in neonates, infants, toddlers, and school-aged children, abdominal pain was the major associated symptom in pre-school children, and vomiting and abdominal pain were the major associated symptoms in adolescents. Hypoactive bowel sound was the major accompanying sign in neonates and infants, and abdominal tenderness was the major accompanying sign in the other four age groups. Plain abdominal radiograph showed intestinal inflation in neonates and intestinal inflation with an air-fluid level in the other five age groups. Histopathological examination was performed for 339 children and the pathological results of intestinal tissue showed small, few, or poorly developed submucosal ganglion cells in neonates, intestinal inflammation/bleeding/necrosis in infants, and appendicitis in the other age groups. Necrotizing enterocolitis was the main cause of abdominal distension in neonates (34.4%), and intestinal obstruction was the main cause in infants (36.8%), toddlers (52.2%), pre-school children (51.7%), school-aged children (62.3%), and adolescents (52.6%). Vomiting is a common symptom in children with abdominal distension in all age groups. Neonates and infants with abdominal distension often present with hypoactive bowel sounds, and children over 1 year old mainly suffer from abdominal tenderness. Necrotizing enterocolitis is the most common cause of neonatal abdominal distension, and abdominal distension in the other age groups is mainly attributed to intestinal obstruction.

Unusual cause of abdominal distension: Infected abdominal cerebrospinal fluid pseudocyst

Unusual cause of abdominal distension: Infected abdominal cerebrospinal fluid pseudocyst

Bilateral renal lymphangiectasia-an unusual cause of abdominal distension and flank pain in a child.

Renal lymphangiectasia (RL, also known as renal lymphangiomatosis or renal lymphangioma or parapelvic lymphangiectasia) is an uncommon benign disorder characterized by dilatation of perirenal, peripelvic and intrarenal lymphatic channels secondary to obstruction (1,2). About five cases of this entity in pediatric age group have been illustrated in literature till date (3-7). Diagnosis is based on the characteristic radiological findings. An 11 years old male patient presented with the history of fatigue, progressively increasing abdominal distension and bilateral flank pain since last 2 months.

G361 Parental photographic monitoring of ascites

Aims Primary Chylous Ascites is a rare cause of abdominal distension in infants. Our patient had six weeks of intravenous octreotide and total parenteral nutrition followed by medium chain triglyceride formula feeding. We describe his monitoring by girth measurement and parental photography. Methods A four week old boy who presented with worsening abdominal distension and discomfort had ultrasound confirmed ascites. At paracentesis, 100 ml of chylous fluid was aspirated. His clinical course was monitored by serial girth measurement and parental photography using a modern mobile telephone. Results Variability in abdominal circumference measurements ([Figure 1][1]) made detection of clinical improvement more difficult than it was with serial photography ([Figure 2][2]). His mother found the photographs helpful in monitoring her son’s progress. ![Abstract G361 Figure 1][3] Abstract G361 Figure 1 Abdominal circumference measurements ![Abstract G361 Figure 2][3] Abstract G361 Figure 2 Clinical improvement via photography Conclusion This superiority of parental photography over formalised girth measurement monitoring in our patient mandates critical review of these techniques. Informal parental photography has been used in assessment of dermatological conditions1 and inguinal hernias.2 Inter-observer variability in measurements of abdominal circumference is recognised.3 Parental photography may increase parents’ perceived involvement in their child’s care in such chronic treatment and promote a family centred approach. We speculate that measurements from technical photographs4 as employed in sports biomechanical studies5 will be the most sensitive tool for clinical assessment of ascites.

CSF pseudocyst: an unusual cause of abdominal distension in a child

Abdominal cerebrospinal fluid pseudocyst is an uncommon complication of ventriculoperitoneal (VP) shunt placement. We present the case of a 4 year old child in whom a VP shunt was placed for tubercular meningitis 5 months earlier. The clinical presentation, classic imaging findings and management of CSF pseudocyst in a child are discussed.

P155 Making sense of shades of grey!: Impact of hospice ultrasound use on patient care

BackgroundPatients with advanced disease require transportation to hospital for ultrasound identification of abnormal fluid and location marking. This is not only exhausting, but introduces service delays, increases work for an...

Ogilvie’s syndrome following posterior spinal arthrodesis for scoliosis

We report Ogilvie's syndrome following posterior spinal arthrodesis on a patient with thoracic and lumbar scoliosis associated with intraspinal anomalies. Postoperative paralytic ileus can commonly complicate scoliosis surgery. Ogilvie's syndrome as a cause of abdominal distension and pain has not been reported following spinal deformity correction and can mimic post-surgical ileus. 12 year old female patient with double thoracic and lumbar scoliosis associated with Arnold-Chiari 1 malformation and syringomyelia. The patient underwent posterior spinal fusion from T4 to L3 with segmental pedicle screw instrumentation and autogenous iliac crest grafting. She developed abdominal distension and pain postoperatively and this deteriorated despite conservative management. Repeat ultrasounds and abdominal computer tomography scans ruled out mechanical obstruction. The clinical presentation and blood parameters excluded toxic megacolon and cecal volvulus. As the symptoms persisted, a laparotomy was performed on postoperative day 16, which demonstrated ragged tears of the colon and cecum. A right hemi-colectomy followed by ileocecal anastomosis was required. The pathological examination of surgical specimens excluded inflammatory bowel disease and vascular abnormalities. The patient made a good recovery following bowel surgery and at latest followup 3.2 years later she had no abdominal complaints and an excellent scoliosis correction. Ogilvie's syndrome should be included in the differential diagnosis of postoperative ileus in patients developing prolonged unexplained abdominal distension and pain after scoliosis correction. Early diagnosis and instigation of conservative management can prevent major morbidity and mortality due to bowel ischemia and perforation.

A rare cause of abdominal distension

A rare cause of abdominal distension

Current significance of meconium plug syndrome

BackgroundThe significance of meconium plug syndrome is dependent on the underlying diagnosis. The incidence of pathologic finding, particularly Hirschsprung's disease, contributing to the presence of these plugs, has been debated. However, there are little recent data in the literature. Therefore, we reviewed our experience with meconium plugs as a cause of abdominal distension to evaluate the associated conditions and incidence of Hirschsprung's disease. MethodsWe reviewed the records of newborns with meconium plugs found in the distal colon on contrast enema from 1994 to 2007. Demographics, radiologic findings, histologic findings, operative findings, and clinical courses were reviewed. ResultsDuring the study period, 77 patients were identified. Mean gestational age was 37.4 weeks and birth weight, 2977 g. Hirschsprung's disease was found in 10 patients (13%). One had ultrashort segment disease and another had total colonic aganglionosis. Maternal diabetes was identified in 6 patients. No patients were diagnosed with cystic fibrosis, meconium ileus, malrotation, or intestinal atresia. ConclusionMeconium plugs found on contrast enema are associated with a 13% incidence of Hirschsprung's disease in our experience. Although all patients with plugs and persistent abnormal stooling patterns should prompt a rectal biopsy and genetic probe, the incidence of Hirschsprung's and cystic fibrosis may not be as high as previously reported.

An unusual cause of abdominal distension

An 85-year-old caucasian female presented with a 1 day history of progressive abdominal distension not associated with pain, nausea or vomiting. The only significant past medical history was of a...

Omental cysts: an unusual cause of abdominal distension in children

Congenital cystic lesions arising in the omentum are a rare finding in the paediatric age group. They are difficult to diagnose preoperatively as they have few distinct features; the diagnosis is often confirmed only at lalaparotomy. They are thought to arise due to a developmental abnormality of the lymphatic system. Two cases are presented and the literature reviewed. The treatment of choice is complete resection. Long-term follow-up is unnecessary due to their benign nature.

Neuroblastoma : Computed Tomographic Finding

Recently many studies have shown the usefulness of computed tomogram in diagnosing abdominal mass when clinical and conventional radiologic examinations fail to reveal the nature of abdominal mass or the cause of abdominal distension. To evaluate the usefulness of CT in diagnosing neuroblastoma, we retrospectively analyzed computed tomographic findings of 16 neuroblastoma patients, who pathologically proved in Yeungnam University Hospital from 1986 to 1995. The age range of the patients studied were from 8months to 18years. The most frequent sith of origin was adrenal gland and the next was retroperitioneum. The presenting symptoms were palpable mass, abdominal distension, and abdominal pain.- The viewpoints of this analysis were tumoral calcifications, midline cross, shape, margin, internal structure, contrast enhancement patterns, major vessel involvement, and lymph node involvement. ':haracteristic CT findings were 'as follows: Fine dense curvillinear calcification within the tumor(56%), midline cross(50%), lobulation(75%), well-circumscribed margin(56%), cystic degeneration(56%), heterogeneous contrast enhancement(690/o), encasement of major vessels such as aorta, IVC and celiac trunk(50%), and paraaortic lymphadenopathy(87%). We conclude that these CT findings were very common and could be helpful in diagnosting and differentiation neuroblastoma in infant and children.