Cause Of Recurrent Abdominal Pain Research Articles

An unusual yet treatable cause of recurrent abdominal pain

An unusual yet treatable cause of recurrent abdominal pain

Etiological Spectrum of Recurrent Abdominal Pain in Preschool Children: A One-Year Comprehensive Investigation Reveals a Predominance of Non-Organic Causes

Background: Recurrent abdominal pain (RAP) is a common concern affecting preschool children, impacting their daily activities. This one-year study, conducted from March 2017 to February 2018, aimed to explore the etiological spectrum of RAP in this age group, with a specific focus on differentiating between organic and non-organic causes. Methods: Eighty preschool children presenting with RAP were enrolled in the study. A comprehensive investigation included thorough interviews, physical examinations, and initial blood, urine, and stool evaluations. Additional diagnostic modalities, such as abdominal ultrasonography, radiography, and endoscopy, were employed. Data analysis involved both descriptive and inferential statistics to categorize and understand the distribution of organic and non-organic causes. Results: Among the 80 preschool children investigated, 37.5% exhibited organic causes, with urinary tract infections (UTIs) being the most prevalent (20%), either alone or coexisting with other parasitic infections. Non-organic causes dominated, comprising 62.5% of cases. Psychosocial factors, including school phobia, sibling rivalry, and familial discord, were identified as significant contributors to RAP. Conclusion: This comprehensive one-year study reveals a notable predominance of non-organic causes of recurrent abdominal pain in preschool children. UTIs were the leading organic cause, while psychosocial factors emerged as significant influencers. These findings underscore the importance of considering both medical and psychosocial aspects in the evaluation and management of RAP in this age group. Further research and instrumental support are warranted to enhance our understanding and refine therapeutic approaches for preschool children with recurrent abdominal pain.

Aetiology and Risk Factor Analysis of Patients with Chronic Pancreatitis Admitted in a Tertiary Hospital

Background: Chronic pancreatitis is defined as a continuing inflammatory disease of the pancreas characterized by irreversible morphologic changes that typically cause pain and/or permanent loss of both exocrine and endocrine function. Chronic pancreatitis can result from episodes of acute pancreatitis of any cause, most commonly in those with multiple relapsing episodes of acute pancreatitis. The objective of our study is to determine the aetiology and risk factor in chronic pancreatitis patients admitted in the hospital. Materials and methods: A retrospective observational study was conducted in the Department of Medicine, Maa- Shishu-O-General Hospital, Chattogram from July 2020 to September 2022. Total 29 patients were selected, as presenting in Medicine Department with documented presentation. All data were taken meeting exclusion criteria and analysed. Results: Mean age, weight, waist circumference and BMI is 35.6 year, 57 kg, 32 cm and 24.5 respectively. Almost 2/3 of the patients admitted from urban area and mostly belong to average socioeconomic groups and male are little bit more affected n=15, 51.7%. Maximum cases were non alcoholic n=18, 62.1%. and found raised Triglyceride n=10, 34.5%. Pancreatic calcification found in significant cases n=14, 48.3%. Conclusion: Chronic pancreatitis is one of the common causes of recurrent abdominal pain. Malnutrition and hypertriglyceridimia is the commonest cause in our country and abdominal x-ray have dramatic role in diagnosis and prognosis also. IAHS Medical Journal Vol 5(2), Dec 2022; 2-5

Helicobacter Pylori Infection among Children with Recurrent Abdominal Pain: A Single Center Study

Background: Recurrent abdominal pain (RAP) is a common problem in children. Mostly it is functional, but due to recent advanced diagnostic technologies more organic causes are identifying. Among the organic causes Helicobacter pylori (H. pylori) infection is common, especially in developing countries. Early detection and treatment of this infection may prevent some serious gastrointestinal problems in later age. Objective: To evaluate the frequency of H. pylori infection as a cause of recurrent abdominal pain in children. Methods: This cross sectional study was conducted among the children with recurrent abdominal pain (RAP) in the pediatric Gastroenterology, Hepatology & Nutrition Department of Bangladesh Shishu Hospital & Institute in Bangladesh from January 2019 to December 2020. A total of 70 patients were included in the study. Demographic data, clinical manifestations, laboratory parameters were recorded in a standard data sheet. All the participants underwent to upper GI endoscopy and gastric biopsy were taken in all the patients. Rapid urease test and histopathology of gastric biopsy samples were done to confirm H. pylori infection. Collected data were checked manually and analyzed by SPSS version 22.0. Association of parameters with infection were done by unpaired t-test, chi-square test and fisher’s exact test. Results: Helicobacter pylori infection in children with RAP was 35.7%. Mean age of the infected children was 9.49±2.47 years with male (52%) predominance. There was significant association of infection with lower socioeconomic class (p=0.003). Patients with RAP for>6 months’ duration were significantly associated with infection (p=0.003). Family size and source of drinking water had no effect on results. Most of the RAP patients with positive infection had poor growth (p=0.003). Pallor, abdominal tenderness or vomiting were not significantly associated clinical manifestations of H. pylori infection. Conclusions: Helicobacter pylori infection is ....

Choledococele as a cause of recurrent abdominal pain and biliary sepsis.

We report the case of a 91-year-old female with acute cholangitis and long-standing symptoms of recurrent colic- related abdominal pain after cholecystectomy. She was diagnosed by abdominal CT of saccular dilation of the intramural bile duct in the duodenum suggesting choledococele. ERCP was performed in which the presumptive diagnosis was confirmed, and choledochotomy and choledochoplasty were done with excellent subsequent progress. Choledococele is the least common type of biliary cyst. It consists of a cystic dilation of the intramural portion of the common bile duct that protrudes into the duodenal lumen and causes symptoms of recurrent abdominal pain and biliary events. ERCP is a key test in both diagnosis and treatment except when they cannot be approached by this technique or malignancy is suspected.

Internal hernia with volvulus – A rare cause of recurrent abdominal pain after frey's procedure

Internal hernia with volvulus – A rare cause of recurrent abdominal pain after frey's procedure

An unusual cause of recurrent abdominal pain in a middle-aged man.

A 54-year-old man was hospitalized with intermittent periumbilical pain for 1-month duration. Abdominal contrast-enhanced computed tomography (CT) revealed target-sign and a fat density mass measuring 2.0 × 2.5-cm in the distal ileum. Part mesenteric tissues and blood vessels were embedded and the wall of the affected intestinal tube was thickened and edematous. His symptom was alleviated after conservative treatment and he refused further management. The patient was hospitalized again with the same symptoms and abdominal CT findings 4 years later. Exploratory laparotomy was performed. A palpable mass in the ileum was found measuring 3.0 × 3.0-cm and partial enterectomy was performed. Postoperative histopathology revealed the resected mass was composed of proliferating mature adipocytes surrounded by few fibrous connective tissue. Hyperplastic fibroblast and inflammatory exudative necrotic tissue were found on the surface of the mass. The patient was diagnosed as ileum fibrolipoma with intussusception. He was discharged home uneventfully and no symptoms was observed in 12 months follow-up.

Diagnosis and Management of Chronic Appendicitis in Children: A Case Report

Background: Abdominal pain was one of the most complaints in children. Chronic appendicitis was the common cause of recurrent abdominal pain. The incidence of this case was 1,5% of all appendicitis cases. The manifestation was not specific, and one of the treatment options was surgical with laparotomy or laparoscopy methods.
 Case presentation: A 10-year-old boy came to the outpatient clinic of gastroenterohepatology with a diagnosis of abdominal pain caused by chronic appendicitis differential diagnosis of chronic gastritis with abdominal pain, especially the pit of the stomach moving to the right waist since 3 months ago. Physical examination of the patient showed the general condition was moderate, conscious, and normal vital signs. Abdominal distension was absent, tenderness in the lower right abdomen was present, and the pain was present in the lower right abdomen. There was contralateral tenderness in the left lower abdomen. An appendicogram examination shows chronic appendicitis. The patient was consulted for pediatric surgery for appendectomy and later controlled to a surgical outpatient clinic after discharge.
 Conclusion: Chronic appendicitis usually shows unspecific manifestation and physical examination. Early diagnosis and surgical treatment are options to treat appendicitis in children.

An unusual cause of recurrent abdominal pain: wandering liver and intestinal malrotation.

An unusual cause of recurrent abdominal pain: wandering liver and intestinal malrotation.

Role of H. Pylori infection with Recurrent Abdominal Pain in Young Age Children

Objective: A study was conducted to determine the incidence of Helicobacter pylori infection in children who had chronic abdominal pain. Study Design: Cross-sectional study. Study and Duration of Study: This research was carried out during 1.1.2019 to 1.6.2020 in the DHQ Sargodha. Materials and Methods: According to the findings, there were 200 participants in the study, and 8 percent of those with Recurrent Abdominal Pain had Helicobacter. Results: The patients ranged in age from 12.43 to 12.43 and 1.23 months on average. Between 8 and 16 years old, the average age of the sample group was observed. The average number of months that participants were bothered by stomach discomfort was 4.23. The presence of Helicobacter pylori was confirmed in 47% of those who were tested. Conclusion: Helicobacter pylori is a common cause of recurrent abdominal pain in children, and it can be treated with antibiotics. In children and adolescents, it is a serious problem, and more research is needed to determine the risk factor that is linked to an increased Helicobacter Pylori infection rate. Keywords: Recurrent Abdominal Pain, abdominal pain, Helicobacter pylori

Congenital cyst in female accessory spleen: a case report

Cysts found in splenic stores, of parasitic or non-parasitic origin, are rare causes of recurrent abdominal pain, but with a significant increase in the number of diagnoses in recent years. This condition is caused by the derivation of the mesothelial cell lining of the spleen capsule, occurring in 0.5 - 2% of the world population. Clinically, patients tend to remain asymptomatic for years and usually have an incidental diagnosis by imaging exams or during the investigation of diffuse and recurrent abdominal pain, rarely found in females. The treatment of splenic cysts is performed through video laparoscopic splenic resection.

Acute primary gastric volvulus occurring after overeating in a 12-year-old girl

Gastric volvulus is a rare cause of recurrent abdominal pain or vomiting. This report presents a case of a 12-year-old girl with acute gastric volvulus and 2-hour history of epigastric pain after overeating. Computed tomography showed severe gastric distension without other abnormal findings. The gastric fluid decompressed through a nasogastric tube was approximately 4,000 mL in volume and non-bilious in color. Upper gastrointestinal series showed organo-axial volvulus without intestinal malrotation. Emergency laparotomy was performed. Because the color of stomach was pinkish, detorsion of the volvulus and gastropexy was performed. Postoperatively, the girl recovered uneventfully.

Recurrent Abdominal Pain in School Age Children

Abstract Background Abdominal pain defined as any type of pain or discomfort that occurs in any area from the lower chest to the groin. Abdominal pain is symptom of a wide variety of mild to serious diseases, disorders, conditions. Abdominal pain can result from infection, malignancy, inflammation, obstruction and other abnormal processes. Aim of the Work To define the causes of recurrent abdominal pain among a sample of school age children. Subjects and Methods This cross sectional study was carried out to evaluate those children who presented to the Pediatric Outpatient Clinic, Children Hospital, Ain Shams University because of recurrent abdominal pain they were diagnosed in the pediatric Gastroenterology unit between June 2016 and July 2017. History taking included full analysis of abdominal pain, associated gastrointestinal symptoms and associated systemic manifestations. Examination included anthropometric measurements, general and local abdominal examination. Routine investigations included complete blood counts, urine analysis and culture, microscopic stool examination and pelviabdominal US. Other specific investigations were selected according to clinical manifestations to reach an organic cause. After reaching the definitive diagnosis, patients were classified into 2 groups organic causes and functional abdominal pain. Results During the study period, 100 children presented with recurrent abdominal pain. Results revealed that only 28% of the recurrent abdominal pain causes were attributed to organic factors; the most commonly encountered organic causes of recurrent abdominal pain were urinary tract infection (12%) while 72% of children presented with functional recurrent abdominal pain. The most common causes of function recurrent abdominal pain in our study was irritable bowel syndrome. Conclusion Most of the cases of RAP among school age children are due to functional abdominal pain (72%).

Abdominal Pain

Key Points Functional abdominal pain disorders are the most common causes of recurrent abdominal pain in pediatrics.The Rome IV criteria in 2016 for functional abdominal pain have eliminated the requirement of "no evidence for organic disease"; it now is defined as > 2 months of pain, ≥ 4 times per month, and after appropriate medical evaluation the symptoms cannot be attributed to another medical condition.History and physical examination are the only evaluations required most of the time in a child with abdominal pain.

Presentation of a rare, highly aggressive peritoneal disease: desmoplastic small round cell tumor and its therapeutic options

SummaryBackgroundDesmoplastic small round cell tumor is a rare highly aggressive peritoneal disease (sarcoma) with mortality rates up to 70% in the first 3 years after diagnosis. It mainly affects young men. Patients clinically complain about diffuse abdominal pain.MethodsThis case report describes the clinical course of a 69-year-old man who presented with recurrent abdominal pain. Physical examination, laboratory testing, imaging, and gastroscopy were performed. Intra-abdominal peritoneal biopsies were taken during diagnostic laparoscopy.ResultsPhysical examination was unremarkable. Laboratory results showed elevated white blood cells, C‑reactive protein, and negative tumor markers. Computed tomography and positron emission tomography scan revealed extensive peritoneal metastases with diffuse intra-abdominal signal intensities and ascites. Gastroscopy was unremarkable, whereas diagnostic laparoscopy confirmed imaging results with a peritoneal cancer index of 39. Extensive immunohistochemical and consecutive molecular investigations led to the diagnosis of an intraperitoneal desmoplastic small round cell tumor.ConclusionOur case report demonstrates a very rare cause of recurrent abdominal pain. Desmoplastic small round cell tumor is a rare and highly aggressive undifferentiated sarcoma, which mainly affects young men. Treatment options include chemotherapy, radiotherapy, cytoreductive surgery, and/or hyperthermic intraperitoneal chemotherapy. Standardized treatment protocols are still lacking because only a few cases have been described so far. Differential diagnoses include all malignancies with peritoneal masses.

Abdominal pain and mass caused by subserosal eosinophilic enteritis

Abstract Eosinophilic gastroenteritis (EGE) causes acute abdomen, which is not diagnosed preoperatively and sometimes requires emergency surgery. Here we report a case of EGE, in which laparoscopy was performed to reveal the cause of recurrent abdominal pain, and a mass lesion was detected. Moreover, we finally diagnosed subserosal layer type of EGE based on the pathological results.

Abdominal epilepsy in patient of schizophrenia - a diagnostic dilemma

Abdominal epilepsy is a rare and uncommon cause of recurrent abdominal pain. It is commonly occurring in children, but rarely in adolescents and elderly. Paroxysmal episodes of abdominal pain with neurological symptoms like dizziness, lethargy, and abnormal electroencephalogram and remarkable response to anticonvulsants confirms the diagnosis. Here we present a case of schizophrenia, who has reported with recurrent abdominal pain for 6 months, and she responded with valproic acid and remained symptoms free.

A112 ANGIOEDEMA,A RARE YET AN IMPORTANT CAUSE OF ABDOMINAL PAIN. A CASE STUDY AND LITERATURE REVIEW

Abstract Background Abdominal pain is a common gastroenterological symptom with an extensive deferential diagnoses. Angioedema is an important cause to remember after the more common causes have been excluded.It is caused by a deficiency in the inhibitor of the first component of classical complement pathway and is divided into hereditary or acquired.Acquired angioedema is associated with autoimmune or lymphoproliferative neoplasms.The clinical features of both include recurrent,self-limiting and circumscribed edema affecting the subcutaneous tissue of the upper respiratory airways and gastrointestinal tract. Aims We describe an interesting case of acquired angioedema presenting with recurrent abdominal pain. We also systematically review the current literature on this rare entity. Methods A search of electronic databases was performed inclusive to September 2019, for all studies and reviews of patients with acquired angioedema manifested as recurrent attacks of abdominal pain. Results: Case Report: 65 year old lady ho has an at least 2 year long history of abdominal pain and bloating associated on some occasions with nausea and vomiting.She presented to our emergency department in August,2018 with a day history of severe generalized abdominal pain and was found to have circumferential thickening,edema with mucosal hyperenhancement involving the distal segment of the small bowel.Splenomegaly was noted on that study.A double balloon enteroscopy was planned,but ultimately cancelled as her ileitis had resolved.The patient was discharged home as her pain resolved with conservative management which included intravenous fluid, pain medications and antiemetics.She then represented to the hospital on September 16, 2019 severe abdominal pain and throat tightness associated with shortness of breath. Again,noted was an extremely short segment of ileum with mucosal edema and hyperenhancement which resolved on a repeat CT scan done during that admission on September 18th, 2019.In light of the patient’s symptoms,CT scan findings,progressive anemia, thrombocytopenia and splenomegaly. It was thought that her abdominal pain is related to secondary to angioedema driven by a lymphoproliferative process as evident by the splenomegaly and worsening cytopenia. A bone marrow was done which revealed clonal B, so the diagnosis of lymphoma was made. The patient’s C1 esterase was 0.2 with reduced functional activity.CH50 less 10 perecent. A diagnosis of acquired angioedema was made and the patient was started on BERINERT 3000 IU SQ every three days with 1500 IU for break through with significant improvement in the frequency and severity of abdominal pain episodes. Conclusions Acquired angioedema is to be considered as a cause of recurrent abdominal pain in a patient with a lymphoproliferative malignancy after common causes and etiologies have been ruled out. Funding Agencies None

Gut microbiome pattern in adolescents with functional gastrointestinal disease.

BackgroundFunctional gastrointestinal disease (FGID) has a worldwide prevalence of 10–45%, and is one of the most common causes of recurrent abdominal pain in children. FGID is characterized with abdominal discomfort and changes in bowel movement. Alteration in gut microbiota is associated with FGID, but data are limited, and there are no data from Indonesia.MethodsA case–control study was conducted in 22 FGID children and 28 healthy subjects aged 13–18 years at the junior high school and senior high school in Central Jakarta. FGID was diagnosed using Rome IV criteria. Age, sex, and level of education were recorded. Stool samples were collected and investigated for Bifidobacterium spp. and Enterobacteriaceae.ResultsMost of the FGID subjects were females (17/22), with a median age of 16 years. The median values of Bifidobacterium spp. were 138.95 (range: 0.2–22,735.8) CFU/gram for the FGID subjects and 232.5 (range: 1.9–38,985.6) CFU/gram in healthy subjects, which showed no statistically significant difference (P = .49). The median values of Enterobacteriaceae were 58.9 (range: 2.5–9577.8) CFU/gram in FGID subjects and 85 (range: 12.1–3139.4) CFU/gram in healthy subjects, which showed no statistically significant difference (P = .94). Our findings indicate that the gut microbiome of adolescents with FGIDs is characterized by a huge variability in levels of Bifidobacterium spp. and Enterobacteriaceae.ConclusionBecause of the wide range detected in the number of Bifidobacterium spp. and Enterobacteriaceae in FGID and healthy subjects, no statistically significant difference was observed. More studies in larger groups of selected patients may be needed.

Autonomic functions and gastric motility in children with functional abdominal pain disorders.

BACKGROUNDAbdominal pain-predominant functional gastrointestinal disorders (AP-FGIDs) are the most common cause of recurrent abdominal pain in children. Despite its high prevalence, the underlying pathophysiology of this condition is poorly understood.AIMTo assess the role of gastric dysmotility and autonomic nervous system dysfunction in the pathophysiology of AP-FGIDs.METHODSOne hundred children, fulfilling Rome III criteria for AP-FGIDs, and 50 healthy controls, aged 5 to 12 years, were recruited after obtaining parental consent. All patients were investigated for underlying organic disorders. Gastric motility and cardiovascular autonomic functions were assessed using validated non-invasive techniques.RESULTSThe main gastric motility parameters assessed (gastric emptying rate [45.7 vs 59.6 in controls], amplitude [48.7 vs 58.2], frequency of antral contractions [8.3 vs 9.4], and antral motility index [4.1 vs 6.4]) were significantly lower in children with AP-FGIDs (P < 0.05). The post-prandial antral dilatation at 1 min after the test meal significantly correlated with the severity of abdominal pain (P < 0.05). Assessment of autonomic functions in AP-FGID patients showed neither a significant difference compared to the control group, nor a correlation with gastric motility abnormalities (P > 0.05). The duration of pain episodes negatively correlated with the parasympathetic tone (maladaptive parasympathetic tone) (P < 0.05).CONCLUSIONChildren with AP-FGIDs have abnormal gastric motility but normal cardiovascular autonomic functions. There is no relationship between abnormal gastric motility and autonomic functions. The pathogenesis of AP-FGIDs is not related to cardiovascular autonomic dysfunction.