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Query: UMLS:C0000727 (acute abdomen)
 3,084 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The case is described of a 33-year-old woman with an 8-year history of oral contraceptive (OC) use who was treated at a hospital in Buenos Aires for a hepatic adenoma. The woman was admitted with an acute abdomen. Apart from OC use she had a history of hypertension for which she was treated with clonidine and diuretics. The physical findings included pain in the right abdomen, involuntary guarding, vomiting, and fever. Ultrasonography showed a normal bladder and pancreas and a nodular image in the right hepatic lobe. A CAT scan revealed a mass in the right hepatic lobe, and a needle biopsy later showed normal hepatic cells. Laparoscopy revealed a solid formation from which blood was obtained on puncturing. Angiography showed tortuous hepatic arteries. Laboratory tests were normal. An exploratory laparotomy was performed when the different studies failed to establish a clear diagnosis. A tumor was found in the right hepatic lobe but was not respected because the frozen section biopsy did not show malignant cells. The definite diagnosis of hepatic adenoma was based on the definitive biopsy. OC treatment was terminated and the tumor was in almost complete remission 1 year later. Hepatic adenomas are benign tumors, usually single, which occur rarely and primarily in women aged 30-40 who use OCs. A review of the literature indicated that the forms of presentation of hepatic adenoma are very varied. Pain was the initial symptom in 12-52% of cases. The pain was of sudden onset in 1/3. Hepatic adenoma is however infrequently considered as a cause of acute abdomen. Treatment in 73% of cases is surgical because of the danger of hemorrhage and shock and because of the potential for malignant transformation.
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PMID:[Acute abdomen as form of presentation of hepatic adenoma]. 307 13

7 case reports of women with benign hepatic adenoma suggest that, since all of the women were taking oral contraceptives (OCs), there may be an association between ingestion of exogenous hormones and development of benign hepatoma of the liver. The cases were rapidly diagnosed by using hepatic arteriography; prompt, precise diagnosis is emphasized because, though the tumors are benign, they may cause serious, if not fatal, hemorrhage if left unchecked. Case 1 was a 26-year-old woman who had taken Enovid for 2 years, who presented with acute abdomen and impending shock. Coliotomy was performed, in which a left-lobe hepatic tumor was found; she underwent left hepatectomy and cholecystectomy and no evidence of recurrence was found 1 year later. Case 2 had been taking Oracon for a unknown time. Case 3, on OCs for 6 years, had a pedunculated mobile tumor removed. Case 4, 25 years old, had been taking Ovral for 6 months before diagnosis and excision of a right lobe liver tumor. Case 5, 5 years on combined OCs, required surgical intervention for a hypervascular mass. Case 6, taking a total of 8 years of OC therapy, was operated on for an hepatic mass which was a white-to-yellow hemorrhagic mass. Case 7, taking Enovid for 7 years, yielded a surgical specimen that was hemorrhagic, partly necrotic, and yellow-tan, about 10 cm in diameter.
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PMID:Possible association between benign hepatomas and oral contraceptives. 412 57

Having read the Feb. 9 paper by Dr. Neuberger and colleagues, we should like to report another case of hepatic adenoma that underwent spontaneous regression upon discontinuance of oral contraceptives. In November 1976, a 55-year old female who had been on norethynodrel with mestranol (Enovid) 5 mg/day for about 10 years without interruption, presented with an acute abdomen. At laparotomy, an enlarged, diffusely bleeding liver was encountered, and biopsy findings were interpreted as hepatic cell adenoma. This was confirmed by Professor William M. Christopherson, University of Louisville School of Medicine, Louisville, Kentucky. A nuclide scan revealed a large mass in the right lobe of the liver. Hepatic angiography disclosed a 6x8 cm avascular mass. The included figures, computerized tomographic scans of the liver done on November 28, 1977 and December 12, 1979, respectively, exhibit reduction in tumor size. The oral contraceptive was discontinued and the patient has remained well.
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PMID:Oral-contraceptive-associated liver tumours. 610 64

Benign tumours of the liver, being rare compared to malignant forms, constitute a big diagnostic and therapeutic problem to prove their benignity and the relation between the patients' symptoms and their existence. During 1983-91, we had the chance to study ten (10) patients with benign liver tumour-six (6) women and four (4) men-with a mean age of 51 years, concerning 5 hemangiomas, one hepatic adenoma and 4 focal nodular hyperplasia. Two of the hemangiomas coexisted with metastatic liver tumours. In seven patients there was surgical confirmation of tumor existence and in the remaining two patients the diagnosis was based upon laboratory findings and imaging techniques. Four patients were asymptomatic and the tumors were identified as an incidental finding during operations concerning the liver and biliary system or under imaging techniques. The disease was confirmed by intraoperative biopsy. Surgical intervention was undertaken to one patient with hepatic adenoma appearing symptoms of acute abdomen and haemorrhagic shook and a partial hepatectomy was attempted. There was no considerations of any therapeutic intervention to the rest of the patients. The diagnostic procedures used by our team to investigate and to follow up the progress of the disease in our series were ultrasonography, CT scan, magnetic tomography and selective hepatic arteriography.
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PMID:[Benign tumors of the liver]. 839 25

Spontaneous hepatic hemorrhage is a rare condition that may be caused by an underlying hepatic tumor, most commonly hepatocellular carcinoma or hepatic adenoma. A spontaneous rupture of a hepatic metastasis from a gastric gastrointestinal stromal tumor is also extremely rare, and the majority of affected patients present with hypovolemic shock or an acute abdomen. In this article, we report the case of a 65-year-old man with a spontaneous rupture of a hepatic metastasis from a gastric gastrointestinal stromal tumor that presented as hypovolemic shock. Cross-sectional imaging studies (computed tomography or magnetic resonance imaging) play a significant role in the diagnosis of this condition and guides its management.
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PMID:A Spontaneously Ruptured Hepatic Metastasis From a Gastric Gastrointestinal Stromal Tumor That Presented as Hemoperitoneum. 2642 88