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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Thirty-seven patients with carcinoma of the extrahepatic bile ducts (EHBD), diagnosed over 14 years from 1974 to 1987, were studied retrospectively. The most common presenting complaint was jaundice, followed by abdominal pain, nausea and vomiting, and weight loss. The majority of EHBD carcinomas were located at the middle third of the bile duct (43.2%), followed by upper third bile duct (37.8%), and lower third bile duct (18.9%). The resectability of the surgically managed group was 44.4%. The most common histologic type was adenocarcinoma. The 30-day postoperative mortality was 30.6%. The mean overall survival of the patients with EHBD carcinoma was 11.2 months. Patients with distal third tumors had the best prognosis with a mean overall survival of 16.0 months. The mean overall survival of patients with upper-third and middle-third tumors were 10.9 months and 9.4 months. A high index of suspicion of the disease as well as earlier, aggressive surgery may improve patient survival.
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PMID:Carcinoma of the extrahepatic bile ducts. 201 Oct 22

Rectal palpation of a 30-year-old mixed-breed mare with chronic weight loss and intermittent, refractory abdominal pain revealed a mass in the right caudoventral portion of the abdomen. Hematologic and serum biochemical findings were normal except for slight mature neutrophilia and mildly high alkaline phosphatase activity and total bilirubin concentration. Cytologic examination of a specimen obtained by abdominocentesis revealed equal numbers of nondegenerative neutrophils and macrophages, but no evidence of neoplastic cells. The mare continued to have signs of abdominal discomfort and was euthanatized. Necropsy revealed a large mass at the junction of the right dorsal colon and transverse colon, and several smaller masses in the liver. Histologic characteristics of the small-colon mass were consistent with colonic adenocarcinoma with osseous metaplasia.
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PMID:Colonic adenocarcinoma with osseous metaplasia in a horse. 201 37

Unusual infections associated with colorectal tumors may, in some instances, be the sole clue to presence of malignancy. The infections are either related to invasion of tissues or organs in close proximity to the tumor or secondary to distant seeding by transient bacteremia arising from necrotic tumors. The authors present one case of spontaneous crepitant cellulitis in the lower abdominal wall, associated with sigmoid tumor. The patient had abdominal pain in the left iliaca fossa, fever and skin necrosis of the lower abdominal wall in the last 4 hours. At surgery they performed debridement and excision of necrotic tissue (lower abdominal wall) and partial sigmoidectomy with sigmoid colostomy. The patient died 9 months after initial surgery. A study of tumor mass revealed an adenocarcinoma. The presence of crepitant cellulitis in a lower abdominal wall should result in a search for bowel perforation.
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PMID:[Crepitant abdominal cellulitis: a rare clinical presentation of sigmoid tumor]. 215 Dec 44

In an attempt to determine the natural history of ductal adenocarcinoma of the pancreas in patients under 40 years of age, we reviewed the surgical outcomes of all such patients seen at the Mayo Clinic from 1970 to 1985. Histologic sections were reviewed; islet cell tumors and cystadenocarcinomas were carefully excluded. Twenty-six patients were identified. Their mean age was 34 years, with only one patient less than 25 years old. Symptoms included primarily abdominal pain, weight loss, and jaundice. One third of patients had a recent or past history of pancreatic disease including pancreatitis, pseudocysts, benign cystadenoma, and choledochal cyst. The tumor was located in the head of the gland in 62% of patients. "Curative" resections were possible in only three patients (12%); the remaining patients underwent palliative bypass (38%), biopsy alone (42%), or a palliative resection (8%). The hospital mortality rate was 12%, with actual 1-, 2-, and 5-year survival rates of 19%, 8%, and 4%, respectively, with a median survival of 4 months. The only long-term survivor underwent biliary bypass at age 15 years for a large neoplasm in the head of the gland; despite biopsy-proved liver metastases at that time, she continues to do well 5 years later. Histologic review indicated this tumor to be a "solid and papillary neoplasm of the pancreas." Ductal adenocarcinoma of the pancreas in young patients is an aggressive tumor with a poor prognosis behaving much like ductal adenocarcinoma in older patients (greater than 40 years). In rare instances a more favorable outcome can be expected when a solid and papillary neoplasm is found.
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PMID:Nonendocrine cancer of the pancreas in patients under age forty years. 216 85

We report a primary malignant mixed mesodermal tumor in the right ovary of 75-year-old woman. She was admitted to Kobe West Municipal Hospital because of an abdominal fullness and an upper abdominal pain. A laparotomy yielded yellowish-clear ascites (2,000 ml) a tumor located in the right ovary, an upper abdominal mass the size of a child's head between the stomach and the transverse colon, and disseminating small tumors of the peritoneum. The left ovary and uterus showed no particular change. Four months after the onset of her symptoms, the patient died of carcinomatous cachexia and dyspnea. On microscope examination, the tumor of right ovary showed combined features of an adenocarcinoma, an adenosquamous carcinoma and a serous cystadenocarcinoma with foci of a heterologous stromal differentiation, that is an area of immature, striated muscle cells, bone, and cartilage and undifferentiated spindle cells. Immunohistochemical stains were useful for determining elements of the tumor cells. Epithelial tumor cells were positive for cytokeratin, epithelial membrane antigen, and CEA, while mesenchymal tumor cells were generally positive for vimentin and the immature muscle cells were especially positive for desmin, actin, and myosin. Additionally, myoglobin was identified in the rhabdomyoblast. Finally, S-100 protein was present in cartilage area and partially present in the adenocarcinomatous element.
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PMID:[A malignant mixed mesodermal tumor of the ovary]. 217 88

Autologous lymphokine-activated killer (LAK) cells and recombinant human interleukin-2 (rIL-2) were administered intraperitoneally (IP) to 24 patients with malignancies limited to the peritoneal space. Ten patients had ovarian cancer, 12 had colorectal cancer, and one patient each had endometrial carcinoma and primary small-bowel adenocarcinoma. All ovarian cancer patients, three of twelve colorectal cancer patients, and one patient with endometrial carcinoma had received prior therapy. Patients received IL-2 100,000 U/kg every 8 hours intravenously (IV) for 3 days, and 2 days later underwent daily leukapheresis for 5 days. LAK cells were generated in vitro by incubating the peripheral blood mononuclear cells in IL-2 for 7 days and were then administered IP daily for 5 days through a Tenckhoff catheter (Davol, Inc, Cranston, RI) together with IL-2 25,000 U/kg IP every 8 hours. All but one patient completed at least one cycle of therapy. Toxic side effects included minor to moderate hypotension, fever, chills, rash, nausea, vomiting, abdominal pain and distension, diarrhea, oliguria, fluid retention, thrombocytopenia, and minor elevations of liver function tests; all of these rapidly improved after discontinuation of IL-2. One patient had a grand mal seizure, and one suffered a colonic perforation; these were felt to be treatment-related. IP fibrosis developed in 14 patients and limited repeated cyclic administration of this therapy in five patients. Two of 10 (20%) ovarian cancer patients and five of 12 (42%) colorectal cancer patients had laparoscopy- or laparotomy-documented partial responses. We conclude that LAK cells and rIL-2 can be administered IP to cancer patients, resulting in moderate to severe short-term toxicity and modest therapeutic efficacy. Further investigation of this form of adoptive immunotherapy modified to address the problem of IP fibrosis and with lower IP IL-2 doses is justified by these initial results.
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PMID:Intraperitoneal lymphokine-activated killer-cell and interleukin-2 therapy for malignancies limited to the peritoneal cavity. 221 99

Secondary esophageal achalasia due to malignancy is a rare condition; only 53 such cases have been reported to date. Sixty-two percent of the cases were due to gastric adenocarcinoma. Mesothelioma of the peritoneum is an uncommon neoplasm. The usual presenting symptoms are abdominal pain, abdominal mass, or abdominal distention. The patient we are reporting had peritoneal mesothelioma which presented with dysphagia and weight loss, in addition to the radiological and manometric picture of achalasia. Secondary achalasia was suspected clinically, and was confirmed by computed tomography and laparotomy. The diagnosis of peritoneal mesothelioma was made only by histopathological examination. We are not aware of any other report documenting the association of peritoneal mesothelioma and achalasia.
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PMID:Peritoneal mesothelioma: an unusual cause of esophageal achalasia. 225 28

Primary adenocarcinoma of the appendix is an uncommon disease frequently diagnosed surgery. It has an occurrence between 0.01 and 0.11% of all appendectomized patients, and it is more often found in patients older than fifty years. Symptoms are usually similar to those seen in acute appendicitis. Some authors consider the mucocele of the appendix a primary carcinoma as it is related with obstruction of the appendix lumen followed by a cystic dilatation with mucosal changes, mucus hypersecretion and extension outside of the appendix. We present one case with abdominal pain, constipation, weight loss of 26 kg, and a mass localized in the right lower quadrant. An exploratory surgery showed a partially retroperitoneal mass of 15 by 20 cm, irregular, cystic, with mucus content and the appendix included in it. The mass was removed and appendectomy was performed. Postoperatively the patient did well. The final pathologic report was a cystadenocarcinoma of the appendix.
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PMID:[Cystadenocarcinoma of the appendix. Report of a case]. 226 47

To assess the contribution of fecal blood testing to cancer detection in a clinical practice setting, we studied records from 160 patients with both a new tissue diagnosis of colorectal adenocarcinoma and a preceding stool blood test (HemoQuant, Mayo Medical Laboratories, Rochester, Minn) determination. In this group, 71% had suggestive colorectal symptoms (particularly stool changes, overt bleeding, and abdominal pain) or anemia at presentation, and 29% were asymptomatic. Fecal blood levels remained normal in more than 40% of both symptomatic and asymptomatic patients. In only 26 patients (16% overall) was an abnormal fecal blood level the sole heralding feature, but this subset of patients had a more favorable stage. Fecal blood levels were higher with advanced, larger, and more proximal tumors and with stools collected before purgation. We conclude that, in the practice setting, fecal blood level elevation alone is an uncommon but important manner of colorectal cancer presentation, most cancers present with symptoms, and fecal blood levels are often normal in both symptomatic and asymptomatic patients.
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PMID:Colorectal cancer detection in the practice setting. Impact of fecal blood testing. 233 Nov 99

Clinicopathologic findings and clinical follow-up data of 31 patients with non-icteric ampullary carcinoma (NIAC) and 111 patients with icteric ampullary carcinoma (IAC) were retrospectively compared. All of the IAC patients presented with obstructive jaundice. Twenty-three of the 31 NIAC patients developed abdominal pain and/or fever caused by cholangitis or pancreatitis, and the remaining eight patients were asymptomatic. The two groups were not significantly different in age, sex, size of the tumor, macroscopic type, lymph node metastasis, perineural invasion, lymphatic permeation, and venous invasion. Eighteen of the 31 NIACs (58%) were in stages I and II, whereas 25 of the 111 IACs (22%) were in stages I and II (p less than 0.01). Seventeen of the 31 NIACs (55%) were papillary adenocarcinoma, compared with 39 of 111 IACs (35%) (p less than 0.05). As to involvement of the biliary tract, the NIAC showed an intraluminal papillary growth in 14 cases (45%), whereas the IAC showed a periductal invasion in 58 cases (52%) (p less than 0.05). The cumulative 5-yr and 10-yr survival rates of 31 patients with NIAC were 57% and 57%, compared with 32% and 23% of 105 patients with IAC (p less than 0.05; p less than 0.01). The survival curve of the NIAC was significantly better than that of the IAC (p less than 0.01). Non-icteric presentation had no independent prognostic value, as determined by multivariate regression analysis. The NIAC fares better than the IAC, because the NIAC includes a greater number of early ampullary carcinoma and papillary adenocarcinoma. The detection of NIAC may therefore product an improvement in the clinical course of ampullary carcinoma.
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PMID:Non-icteric ampullary carcinoma with a favorable prognosis. 237 29


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