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

From 1950 through 1984, 48 cases of primary tumors of the small bowel were treated at the First Surgical Clinic of the University, La Sapienza, of Rome. Forty-three were malignant and five were benign tumors: 13 in the duodenum, 16 in the jejunum and 19 in the ileum. Abdominal pain, weight loss and obstruction were the most common complaints at admission. Radiographic studies of the gastrointestinal tract were diagnostic in 48% of patients. Four benign tumors were leiomyoma of the jejunum or ileum, the other benign tumor was a Brunner's adenomatosis of the duodenal bulb. The tumors were adenocarcinomatous in 29% of the cases and 50% of them were located in the duodenum. The five-year survival of patients with adenocarcinoma was 11%. The fourteen lymphomas were distributed evenly throughout the small bowel: 40% of the patients with lymphoma were alive after five years. Malignant smooth muscle tumors were found in the jejunum and ileum, in these cases the five-year survival rate was 50%. All the carcinoid tumors were in the ileum. The best five-year survival rate, 66%, was seen in patients with this type of tumor. In the malignant group, the five-year survival rate after curative resections was 25% in patients with positive nodes and 75% in those without nodal involvement.
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PMID:Primary tumors of the small intestine. 383 39

Fifty-five patients with primary small bowel malignancies were evaluated from 1955 to 1983. Twenty-seven patients (49%) had carcinoid tumors, 16 (29%) had adenocarcinomas, and 12 (22%) had leiomyosarcomas. The average age at presentation was 68 years (range: carcinoids, 27-82; leiomyosarcomas, 36-75; adenocarcinomas, 40-83). Carcinoids and leiomyosarcomas were 1.7 and 2.0 times, respectively, more common in men; adenocarcinomas showed no sex predominance. Eighty-nine per cent of all patients had symptoms: abdominal pain in 65 per cent, obstruction in 23 per cent, bleeding in 8 per cent, and palpable mass in 5 per cent. Although 27 per cent of carcinoid patients were asymptomatic, 40 per cent exhibited the carcinoid syndrome. Symptoms were longstanding in the majority of cases, and, at the time of diagnosis, 49 per cent of the carcinomas were metastatic. Fifty-five per cent of the tumors were in the ileum, 24 per cent in the jejunum, and 21 per cent in the duodenum. Fifty-five patients (89%) underwent resection for palliation or cure. Five adenocarcinoma patients (32%) survived 1 year, and one (6%) lived 10 years. Twenty-five per cent of leiomyosarcoma patients survived for 10 years. Eighty-seven per cent of patients with carcinoids survived for 1 year, 39 per cent for 5 years, and 22 per cent for 10 years. Previous reports have documented the difficulty of diagnosing these lesions, as does the present study. A higher degree of physician awareness and a more aggressive investigation of referable symptoms should lead to earlier treatment and better long-term results.
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PMID:Primary small bowel malignancies. 396 20

A 55-year-old woman with an ovarian carcinoid presented with intermittent facial and cervical flushing for 10 years, watery diarrhea for 4 years, and abdominal pain without hepatomegaly. Markedly elevated systemic venous and arterial serotonin levels (830 ng/ml; nl = 50-200 ng/ml) were found. The highest serotonin levels were observed in the superior vena caval system, but serotonin as a marker for tumor localization was inaccurate and led to an unproductive neck exploration. The histological pattern of this tumor contained purely insular elements. No hepatic or nodal metastases were identified and the lesion was unilateral. Substance P levels were elevated in the venous drainage of the left ovary and in retrospect correctly localized the ovarian tumor. This peptide may prove to be another carcinoid tumor marker in addition to serotonin and 5-hydroxyindoleacetic acid. Substance P may also be an important mediator of symptoms in patients with carcinoid syndrome.
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PMID:Substance P in the localization of a carcinoid tumor. 620 86

Eight patients with metastatic carcinoid tumors and the carcinoid syndrome were treated with gelatin foam embolization of the hepatic arterial tree. The aims were to reduce the tumor mass in the liver and to eliminate the carcinoid syndrome. The effects of the treatment were judged from arteriograms, CT scans, and the levels of serotonin in blood and 5-HIAA in urine, as well as from the clinical symptoms. The mean follow-up time was 12.5 months. In all patients the liver tumor mass was reduced after embolization, and this reduction persisted for at least 6 months in seven patients. After treatment, reduced serotonin levels in blood were measured in four patients and reduced 5-HIAA levels in urine in seven patients. In five patients the carcinoid syndrome disappeared after embolization, but after 6 months two of these five patients had regained symptoms. Adverse reactions were minor consisting of a slight fever, reversibly increased serum levels of liver enzymes, and abdominal pain. In our experience, the hepatic embolization is a simple and safe method of giving relief from the carcinoid syndrome.
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PMID:Embolization of the liver in the management of metastatic carcinoid tumors. 620 26

The occurrence of both gastrointestinal carcinoid and von Recklinghausen's disease in the same patient is uncommon. There seems to be a predilection for ampullary carcinoids in these patients. This article reports the sixth case, including a review of the literature and a brief discussion of the implications of this finding. A carcinoid tumor should be suspected in any patient with von Recklinghausen's disease presenting with gastrointestinal bleeding, obstruction, abdominal pain, and particularly obstructive jaundice.
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PMID:Von Recklinghausen's disease associated with gastrointestinal carcinoid tumors. 640 32

In a 32-year-old woman presenting with fever, vomiting and right upper abdominal pain a tumor of the papilla of Vater was detected endoscopically and removed surgically. Histologically it was a carcinoid shown immunohistochemically to produce calcitonin. The tumor had metastasized to a lymph node in the hepatoduodenal ligament. Clinically the patient showed typical signs of von Recklinghausen neurofibromatosis. A survey of the literature suggests that carcinoid of the papilla of Vater may be more frequent in patients with neurofibromatosis. Possible relationships between neurofibromatosis and carcinoid are discussed in the light of the pertinent literature.
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PMID:[Calcitonin-producing duodenal carcinoid in Recklinghausen's neurofibromatosis. Clinical case report and review of the literature]. 641 May 2

Two family groups with familial carcinoid tumours with metastases are presented. These are the fourth and fifth family groups to be reported which do not occur within the setting of the multiple endocrine neoplasia (MEN) syndrome. Relatives of patients with carcinoid tumours having persistent vague abdominal pain or gastrointestinal symptoms should be investigated.
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PMID:Familial occurrence in carcinoid tumours. 657 48

Three cases of primary trabecular carcinoid tumor of the ovary are reported. In two cases the tumor was a pure trabecular carcinoid, while the third it was associated with mature cystic teratoma. The patients were aged 36, 48 and 56 years. The presenting symptoms were lower abdominal pain and the presence of a lower abdominal mass. In one case the tumor was found incidentally. There was no evidence of metastases or carcinoid syndrome in any of these cases. The treatment was bilateral salpingo-oophorectomy and hysterectomy in two cases and bilateral salpingo-oophorectomy in one case. All the patients are well and disease-free for periods ranging from 4-13 years after surgery. The pathology, differential diagnosis and behavior of this entity are discussed and reviewed. Primary trabecular carcinoid of the ovary is an uncommon ovarian tumor, behaving like a tumor of low malignant potential. In the younger patient the treatment is unilateral salpingo-oophorectomy, while in the postmenopausal patient bilateral salpingo-oophorectomy and hysterectomy is the treatment of choice. Long-term follow-up is advisable.
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PMID:Primary trabecular carcinoid tumor of the ovary. 710 79

Twenty-six cases of carcinoid-related mesenteric angiopathy and intestinal infarction (three from our institution and 23 previously reported cases) were reviewed. Twenty patients presented with acute abdominal findings, including peritonitis (13 cases), intestinal obstruction (five cases), and bleeding per rectum (two cases). Fifteen patients (75%) experienced antecedent symptoms of abdominal pain and/or diarrhea, averaging 2.5 years in duration. Twelve patients (46%) exhibited symptoms of carcinoid syndrome. Mesenteric angiography in three cases demonstrated encasement and segmental branch narrowing or occlusion of major mesenteric vessels. Eleven patients underwent resection and primary bowel anastomosis with an early survival rate of 91%. Four additional patients who underwent lesser surgical procedures and five patients who did not undergo operation all died. Elastic vascular sclerosis (EVS) was identified in 19 of 22 cases with available histologic material (86%). These changes were observed in proximity to as well as distant to the primary tumor. In general, the severity of EVS did not correlate with the likelihood of gut ischemia. Although not the sole cause of intestinal gangrene in patients with midgut carcinoids, EVS may contribute significantly to the evolution of these ischemic changes.
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PMID:Mesenteric angiopathy, intestinal gangrene, and midgut carcinoids. 728 Oct 10

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.
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PMID:Primary malignant tumors of the small bowel. 742 15


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