Abdominal pain and gastrointestinal symptoms

Abdominal pain should always be taken seriously, as peritoneal signs may be absent. Acute appendicitis, cholecystitis, perforated gastric or duodenal ulcers, and divertic-ulitis can be sources of rapid deterioration. Bacterial infections of the upper urinary tract or biliary system are more likely to be severe in the presence of obstruction due to kidney stones, tumor, or choledocholithiasis.

Neutropenic enterocolitis (typhlitis) is a feared complication involving infection of the intestinal wall. Typhlitis may progress to full-thickness involvement of the right colon, with necrosis and gangrene of the cecum. Though classically associated with Pseudomonas, typhlitis may be caused by other Gram-negative bacteria. Surgery may be required, but milder cases may be managed with protracted antibiotic therapy.

C. difficile colitis may occur due to use of antibiotics. Wall thickening of the colon on CT scans due to C. difficile may be confused with typhlitis. C. difficile colitis is more ominous in the setting of ileus and abdominal distention without diarrhea. Repeated plain films of the abdomen can identify colonic dilatation. A stool sample for C. difficile toxin assay should be obtained, but occasional false negatives may occur.

51 Tips for Dealing with Kidney Stones

51 Tips for Dealing with Kidney Stones

Do you have kidney stones? Do you think you do, but aren’t sure? Do you get them often, and need some preventative advice? 51 Tips for Dealing with Kidney Stones can help.

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