Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Various reviews documenting the rarity, diagnostic problems, and poor survival statistics prompted this retrospective clinicopathological study of 58 cases of primary small bowel tumors, periampullary and mesenteric tumors excluded, over a 14-year period between 1966 and 1979 inclusive. Of these cases 36 were male and 22 were female, ranging in age from 13 to 65 years. Initially, the symptoms were vague and ill defined. Prominent clinical features were: intermittent abdominal pain (6+%), loss of weight (62%), abdominal lump (53%), and chronic bleeding (7%). Routine barium meal examination and laboratory investigations were not helpful in preoperative diagnosis. Of these tumors 28 were benign and 30 malignant, with the commonest benign and malignant tumors being leiomyoma and lymphoma, respectively. The commonest site of involvement was the ileum both for benign and malignant lesions. None of the benign tumors was found in the duodenum. All patients with benign tumors, discovered either at laparotomy for intestinal obstruction or during surgical procedures for other diseases, had excision of the tumor through enterotomy or resection of small bowel with end-to-end anastomosis. Of 30 patients with malignant tumors, 12 underwent resection of the growth and end-to-end anastomosis. Of the remaining 18 unresectable cases, 7 had by-pass procedures and 11 had only biopsy. All patients of benign tumors are well without any gastrointestinal symptoms. All the malignant cases, except three cases of adenocarcinoma and two of lymphoma who underwent resection, died within 5 years. The 5-year survival of only 8.6% in malignant tumors indicates the necessity of an early exploratory laparotomy in doubtful cases with vague abdominal symptoms. A bold interventionist approach should improve the otherwise dismal outlook of malignant small bowel tumors.
 ...
PMID:Primary tumors of the small bowel: a clinicopathological study of 58 cases. 708 85

The most common cause of colonic obstruction is adenocarcinoma, followed by diverticulitis, volvulus, and a variety of miscellaneous causes. Most signs and symptoms, from whatever cause, consist of abdominal pain with distention and the inability to pass flatus or stool. The clinical diagnosis is confirmed by x-ray studies. Plain films of the abdomen in various positions, chest films, and the addition of contrast studies verify the cause of the obstruction in most instances. The differentiation between neoplasm and diverticulitis causing the obstruction can be difficult or impossible at times, and may become apparent only after the obstruction begins to resolve with conservative management, or the cause is discovered at surgery. The history of previous abdominal or pelvic irradiation, surgery, and inflammatory bowel disease often causes difficulty in the differential diagnosis.
 ...
PMID:The diagnosis of colonic obstruction. 711 69

A 64-year-old man presented with a history of four days of lower abdominal pain and 12 hours of cutaneous discoloration, bullae formation, and swelling of the soft tissues of abdominal wall and right thigh. Myonecrosis of abdominal wall and an adenocarcinoma of the cecum were found at operation. Cultures of blood and fluid from the bullae yielded Clostridium septicum. Nontraumatic clostridial myonecrosis is a fulminant, usually fatal disease that is most often the result of bacteremia from an occult gastrointestinal lesion. Ulceration of the colon or terminal ileum is the most common predisposing condition, and is usually due to gastrointestinal or hematological malignancy. Patients often present with nonspecific complaints, including pain at the affected site and fever. The disease progresses rapidly to include bronze discoloration, edema, and hemorrhagic bullous lesions of the skin, subcutaneous emphysema, and myonecrosis. Presumptive diagnosis often can be made by Gram stain of the bullous fluid that reveals gram-positive bacilli and a paucity of leukocytes. Favorable outcome depends on prompt institution of appropriate antimicrobial therapy and surgical debridement of involved soft tissues, as well as correction of the underlying disorder. This disease should be considered to be a medical-surgical emergency.
 ...
PMID:Nontraumatic clostridial myonecrosis: an infectious disease emergency. 723 41

Primary malignant tumors of the small bowel are uncommon and are often diagnosed at an advanced stage. A 10 year survey (1967 to 1977) of the clinical records at one hospital revealed 39 cases of primary malignant tumors of the small bowel. The most common symptoms were abdominal pain (89.7 percent) and weight loss (77 percent). Six patients presented with complications of enterovesical fistula, bleeding and perforation. Preoperative diagnosis was suspected in 27 cases (69.2 percent). Adenocarcinoma was the most common tumor, followed by carcinoid tumor, lymphoma, leiomyosarcoma and melanoma. The treatment of choice was surgical resection whenever possible. Curative resection was attempted in 25 cases. Adjuvant radiotherapy and chemotherapy was used in four patients with lymphoma. Twenty-seven patients (69.2 percent) are alive from 1 to 6 years after diagnosis and treatment. The 5 year survival rate is 35 percent. Earlier diagnosis is essential if the prognosis for patients with small bowel malignancy is to be improved.
 ...
PMID:Primary malignant tumors of the small bowel. 742 15

Villous adenomas of the upper gastrointestinal tract, although rare, are difficult to diagnose and treat because of their location, invasiveness, and association with adenocarcinoma. Two patients with duodenal villous adenoma and upper abdominal pain as the presenting symptoms are described. Endoscopy is important for early diagnosis. The recommended treatment is simple excision with biopsy, or pancreaticoduodenectomy if adenocarcinoma is present.
 ...
PMID:Duodenal villous adenoma. 743 42

Adenocarcinoma of the small intestine complicating coeliac disease is uncommon. Only 14 cases have been reported, and in only one of these was a jejunal biopsy carried out more than eight months before the diagnosis of malignancy. We describe four more patients with this association, all with long histories of coeliac disease, confirmed in three by jejunal biopsy over five years before the diagnosis of malignancy. Important presenting features of carcinoma were abdominal pain, anaemia, occult gastrointestinal bleeding, abdominal mass, and intestinal obstruction, and these were the main indications for operation. After resection of the tumour survival may be prolonged, as evidenced by one of our cases who remains well eight years after surgery.
 ...
PMID:Adenocarcinoma of the upper small bowel complicating coeliac disease. 745 May 57

We encountered a case of non-curatively resected gastric cancer (p1, n4) who responded well to sequential MTX/5-FU therapy and PMUE therapy. A 63-year-old man was admitted to our hospital with complaints of nausea and vomiting. Upper gastrointestinal examination and CT scan revealed Borrmann type 3 gastric cancer with pyloric stenosis and multiple paraaortic lymphnodal metastasis. The patient underwent palliative gastrectomy for extensive gastric cancer (H0, P1, N4, T3, Stage IV b). Histological examination of the resected stomach revealed poorly differentiated adenocarcinoma with paraaortic lymphnodes metastasis (n4) and peritoneal dissemination (p1). Chemotherapy with sequential MTX/5-FU was given 13 times. Ten months after the operation, abdominal pain and back pain required analgesic treatment. Abdominal CT scan revealed increased size of paraaortic lymphnodes, suggesting recurrence. Sequential MTX/5-FU therapy was switched by PMUE therapy. Lymphnode size became smaller and habitual analgesics could be discontinued. Since then he was given MTX/5-FU and PMUE therapies alternately on an ambulant basis. The patient resumed his daily activities at 2 years and 8 months after the operation.
 ...
PMID:[A case of gastric cancer responding well to MTX/5-FU (methotrexate/5-fluorouracil) and PMUE (CDDP, MMC, UFT, etoposide) therapies upon lymphnode recurrence]. 748 28

In a retrospective analysis, we studied 24 cases of malignant small bowel tumors. Apart from 9 cases of a carcinoid tumor, there occurred 6 cases of leiomyosarcoma and another 7 cases of adenocarcinoma. One case of malignant schwannoma and another case of lymphoma were also seen. Sonography and contrast-study of the GI-tract were the decisive diagnostic tools. Nevertheless, months and even years elapsed before diagnosis was established. Only in 13 patients curative resection could be accomplished. In the remainder of patients, hepatic metastases were found or the tumor could not be resected any more owing to its size. In 6 patients with synchronous and in 7 patients with metachronous liver metastases we carried out palliative regional intraarterial chemotherapy of the liver. The mean survival time of the whole patient group was 19 months. Patients, having submitted themselves to a complete resection of the tumor, had a significantly longer period of survival (mean survival time 25 months) in contrast to patients, having undergone a mere palliative operative procedure (mean survival time 14 months). Mean survival time for leiomyosarcoma was 38 months, for adenocarcinoma 14 months, and for carcinoid tumors 22 months. Owing to difficulties in establishing diagnosis, a tumor of the small intestine should be considered in any patient complaining of abdominal pain.
 ...
PMID:[Malignant tumors of the small intestine]. 752 78

Peritoneal serous papillary carcinoma is a rare primary tumor of the peritoneum. We report here a case diagnosed by laparoscopy, and summarize the clinicopathological features previously reported in patients with this tumor. Laparoscopy was performed in a 66-year-old woman with high-protein ascites and a three-month history of lower abdominal pain. Macroscopically, the parietal and visceral peritoneum was studded with prominent white nodules up to 5 mm in diameter. Multiple biopsies revealed a tubulopapillary serous adenocarcinoma. After exclusion of metastatic peritoneal carcinomatosis (especially ovarian cancer) and malignant mesothelioma, the diagnosis of peritoneal serous papillary carcinoma was established. The patient was placed on chemotherapy (first-line: 5-fluorouracil, adriamycin, and mitomycin C; second-line: paclitaxel). She died 22 months after diagnosis. The present case is also remarkable for the coexistence of granulomatous peritonitis overshadowing the malignant nature of the process. This case report emphasizes the importance of laparoscopy with multiple biopsies in the workup of undetermined exudative ascites.
 ...
PMID:Laparoscopic diagnosis of peritoneal serous papillary carcinoma. 755 42

A 13-year-old boy presented with carcinoma of the ascending colon. He had had intermittent abdominal pain for about one year, with body weight loss, prior to admission. Physical examination showed diffuse abdominal tenderness, but no palpable mass. Lower GI barium study and colonofibroscopic examination showed a protruding mass over the proximal ascending colon. At operation, right hemicolectomy with ileotransversecolostomy was performed, the pathologic finding was adenocarcinoma, signet-ring cell type. Although chemotherapy with 5-fluorouracil, mitomycin, and levamisole were given subsequently, the patient expired one year after surgery because of multiple metastasis. Carcinoma of the colon is extremely rare in the young. Mucin-producing adenocarcinoma is the most predominant type of colon cancer, and most are of signet-ring cell carcinoma. While prognosis is relatively bright in adult, the prognosis is quite unfavorable in children because of the preponderance of the poor histological characteristics and the difficulty of diagnosis.
 ...
PMID:Carcinoma of the colon in a child. 761 77


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>