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

Inside the germinal neoplasms of the ovary, the monodermic or specializad teratomas constitute a not very frequent variety. The struma ovarii represents 2.7% as the form more common of this teratomas type, constituted by thyroid tissue. Struma ovarii can associate to other tumors of the ovary of germinal type as dermoid cyst, carcinoid tumor or non germinal tumors as type as dermoid cyst, carcinoid tumor or non germinal tumors as mucinous or serous cyst or Brenner tumor. Most of the struma ovarii are benign and 5-10% only are malignant, of these group 40% has only associated to extraovaric dissemination. The objective of the present work is to analyze the clinical, epidemical and biological characteristics of the struma ovarii. Eight cases of struma ovarii are presented, that occupy 4% inside the ovary tumors diagnosed and treated in our hospital. The clinical charac-teristics of these tumors were: age average 45.5 tears, pelvic mass accompanied by distension and abdominal pain. They were managed as anyone ovary tumor, in not any case the diagnosis it was suspected, 4 were presented of the left side and 4 in the right, the weight average was 726.2 g. Only in 4 cases was carried out the transoperative diagnosis and the eight cases confirmed in the postoperative. In not any case hyperthyroid symptoms, neither morphological criteria of malignancy were presented. Only in two cases the struma ovarii was reported as pure, in the 6 remaining it is accompanied with another type of ovarian neoplasm.
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PMID:[Struma ovarii: a variety of monodermic teratoma of the ovary. Report of 8 cases]. 1036 13

Primary tumors of the jejunum-ileum are rare and constitute about 2% of gastrointestinal neoplasms. The first clinically reported small bowel tumor was a jejunal carcinoma described in 1824 by Sorlin. The authors reviewed our surgical experience of 9 patients treated at the Department of General Surgery of the "E. Franchini" Hospital of Montecchio Emilia (Re) during a 13-years period from 1984 to 1997. On the basis of literature on the topic, the following are taken into consideration, the history, the incidence, the epidemiology, the aetiopathogenesis, the clinical characteristics, the diagnostic, the surgical therapy of these tumors. The subjects included 6 males and 3 females. The average age of the patients was 66 years, with a male predominance ratio of 2:1. Of the seven primary malignant tumors observed, two patients had adenocarcinomas, two had leiomyosarcomas, two had lymphomas and one carcinoid. The benign tumors were respectively leiomyomas and small intestinal stromal tumor. The most common signs and symptoms were abdominal pain and obstruction of the intestine. Preoperative diagnosis was established in 4 of these patients only by roentgenographic examinations, in 2 by ultrasound scan, in 2 by ultrasound scan and computed tomography, in 1 by endoscopic examination. All the 9 tumors were resected: in 7 patients (77.7%) the resection were considered as curative and in 2 patients (22.3%) palliative. All operated patients were staged by the TNM-classification using pathological and surgical reports. The staging of the disease was the following: 2 patients with stage 1 (T2N0M0), 2 patients with stage II (T4N0M0), 3 patients with stage III (1 with T3N1M0 and 2 with T4N1M0), 2 patients with stage IV (T4N1M1). Survival correlated with the different TNM stage: the median survival time was 60 months for stage I, 60.5 months for stage II, 40 months for stage III and 18 months for stage IV.
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PMID:[Primary neoplasms of the jejunum-ileum. The clinico-diagnostic and surgical therapy considerations: the clinical cases and a retrospective study of our experience]. 1050 68

A 69-year-old male was admitted to an outside institution for severe right abdominal pain radiating to the flank. An extensive work-up, including lower GI series, IVP, and ultrasound of the kidneys were normal. Ultrasound of the liver demonstrated a thickened gallbladder as well as cholelithiasis. Despite some improvement, his symptoms returned intermittently and cholecystectomy was performed. Pathologic examination of the gallbladder showed a carcinoid tumor, 5.4 mm in maximum diameter, in the cystic duct. A small metastatic focus was also found in the cystic duct lymph node. In this paper we compare the clinical presentation, pathological findings and outcome of this case to the previously reported six cases of cystic duct carcinoid. A comparison is also made between the general features of carcinoid at this rare location and the more common gastrointestinal carcinoid.
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PMID:Carcinoid tumor of the cystic duct. 1054 35

Primary pancreatic carcinoid is an extremely rare pancreatic neoplasm. It differs from other primary pancreatic tumours in cytoarchitecture, immunocytochemistry and biologic behaviour. Recognition of this rare entity is of vital importance having considerable therapeutic and prognostic implications. We report a case of an exophytic, pancreatic body carcinoid tumour in a man who presented with abdominal pain. The diagnosis was established by histopathological examination of the core biopsy specimen. A surgical resection of the lesion was done successfully and the patient made a satisfactory recovery from the operation.
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PMID:Pancreatic carcinoid: an unusual tumour in an uncommon location. 1070 82

Alosetron is a potent and highly selective serotonin 5-HT3 receptor antagonist which has been evaluated for the management of irritable bowel syndrome (IBS). It blocked the fast 5HT3-mediated depolarisation of guinea-pig myenteric and submucosal neurons in vitro, with half-maximal inhibition at approximately 55 nmol/L. Alosetron attenuated the visceral nociceptive effect of rectal distension in conscious or anaesthetised dogs. It increased the compliance of the colon to distension in patients with IBS and delayed colonic transit in patients with IBS or carcinoid diarrhoea and in healthy volunteers. A single dose of alosetron 4 mg increased in vivo fluid absorption in normal human small intestine. In clinical trials in patients with IBS, alosetron 1 mg twice daily was effective in relieving abdominal pain and discomfort. Alosetron was most effective in female patients and particularly in those with diarrhoea-predominant IBS. In patients with IBS and healthy volunteers who received alosetron, the most common adverse event was constipation.
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PMID:Alosetron. 1077 33

Tumors of the small intestine are relatively rare. The diagnosis is difficult to establish because the symptoms are vague and non-specific. Although the small intestine constitutes 75% of the length and over 90% of the mucosal surface area of the gastrointestinal tract, only 1 to 2% of gastrointestinal malignancies occur in this segment. Metastases are usually present at the time of diagnosis. The outcome of these patients can be improved if the possibility of a malignant small bowel tumor is considered in all cases of unexplained abdominal pain or gastrointestinal bleeding, especially in younger age. Malignant tumors occur with increasing frequency in distal small bowel with a preponderance of malignant lesions in the ileum compared with the jejunum and the duodenum. Adenocarcinoma is the most common tumor of the primary malignant small bowel tumors, followed by carcinoid, lymphoma and leiomyosarcoma. Mesenchymal tumors of the gastrointestinal tract, traditionally regarded as smooth muscle tumors, have demonstrated different cellular differentiations based on immunohistochemical and ultrastructural features. Therefore the terms leiomyoma and leiomyosarcoma have been replaced by a more encompassing term, gastrointestinal stromal tumor (GIST). The majority of GISTs occurs in the stomach; stromal tumors involving the small intestine (SISTs) are far less common but seem to have greater malignant potential. The clinical a case of a small intestinal stromal tumor (SIST), localised in the jejunum and characterised by an uncertain histological aspect, is presented and a review of the literature is made.
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PMID:[Gastrointestinal stromal tumors. A case of small intestine stromal tumor (SIST) with an uncertain biological aspect]. 1095 71

Long-acting depot forms of somatostatin analogs administered by intramuscular injections are now available for the treatment of neuroendocrine tumors (NETs). In the present study, we investigated the efficacy and tolerability of a slow-release form of lanreotide in patients with advanced NETs. From July 1996 to January 1999, 25 patients with advanced NETs (12 carcinoids, 13 endocrine pancreatic tumors) were enrolled in the study. Thirteen patients were pretreated with subcutaneous octreotide, chemotherapy, or hepatic metastasis alcoholization. All the patients had measurable disease. Seventeen patients were symptomatic and 20 patients had elevated serum and/or urine markers. Octreotide scintigraphy was positive in 23 of 25 patients. Lanreotide was administered as intramuscular injections at the dose of 30 mg every 2 weeks until there was objective, biochemical, or symptomatic tumor progression. Objective partial responses (PRs) were documented in 2 patients (8%), whereas 10 patients (40%) had tumor stabilization. The PRs were observed in patients with midgut carcinoids, of whom one was pretreated with subcutaneous octreotide. The response duration was 21+ and 24+ months in responding patients; the median duration of disease stabilization was 8.5 months (range, 4-21+). The overall biochemical response rate was 42%, including 2 complete responses (CRs) (10.5%) and 6 PRs (31.5%); all biochemical responses were observed mostly in patients with carcinoid tumors; the duration of response was 18+ and 30+ months for CRs; the median duration of biochemical response was 7 months (range, 4-18+) for PRs. The overall symptomatic response rate was 70% with a median duration of 7.5, 18, and 18+ months for diarrhea, abdominal pain, and flushing, respectively. Median duration of lanreotide treatment was 10 months (range, 2-30+). No significant side effects were reported. Depot lanreotide 30 mg shows significant efficacy in terms of objective response rate and in biochemical and symptomatic control, in pretreated patients as well as nonpretreated patients with advanced NETs. Tolerability is good, with good patient compliance.
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PMID:Long-acting depot lanreotide in the treatment of patients with advanced neuroendocrine tumors. 1095 74

Carcinoid tumors arise from enterochromaffin or enterochromaffin-like cells that are present in the gastrointestinal tract, ovaries, and lungs. Over 90% of carcinoids originate in the gastrointestinal tract with the most common sites in order of frequency being the appendix, terminal ileum, rectum, and the remainder of the colon. Gastroduodenal and pancreatic carcinoids are infrequent. Carcinoid syndrome is associated with small intestine carcinoids in about 40%. Common symptoms include intermittent intestinal obstruction with crampy abdominal pain and vomiting, and weight loss. Upper gastrointestinal bleeding with melaena or hematochezia is a relatively rare early symptom of patients with small intestine carcinoid tumors. We report on a 69-year-old man, treated with acenocoumarol for previous thromboembolic complications of hereditary protein S deficiency. He was admitted to hospital because of an acute episode of hematochezia followed by melaena. Endoscopic evaluation of esophagus, stomach, duodenum and colonoscopy revealed no apparent source of bleeding. Selective angiographic evaluation of mesenterial arteries showed pathologic vasculature approximately in mid jejunum. Laparotomy revealed bleeding from a small submucosal malignant carcinoid tumor in small intestine and multiple large metastases within mesenteric tissue. Segmental resection of small intestine and exstirpation of the metastatic masses was performed. Postoperative period was uneventful. Cytotoxic chemotherapy in this adjuvant setting has not been recommended. Small intestinal carcinoid tumor has to be considered as a rare cause of gastrointestinal bleeding with melaena or hematochezia. Nevertheless, bleeding is a relatively rare early symptom of patients with small intestine carcinoid tumor.
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PMID:[Gastrointestinal hemorrhage needing blood transfusion as the first manifestation of small bowel carcinoid tumor]. 1103 87

With adequate medical management the midgut carcinoid tumor generally is an indolent malignancy associated with substantial life expectancy and appreciable life quality, even in the presence of liver metastases and significant tumor burden. Abdominal complications may occur in this entity of carcinoids owing to entrapment of intestines and encasement of mesenteric vessels by mesenteric metastases and associated marked mesenteric fibrosis. This may be the cause of abdominal pain, disabling diarrhea, weight loss to the extent of malnutrition, and eventually the risk of death with acute or chronic intestinal obstruction or intestinal gangrene. Operative removal of the mesentericointestinal lesion is often indicated to prevent or treat these complications but may be technically difficult when mesenteric metastases extend in the vicinity of major vessels in the mesenteric root. At laparotomy 56 patients with advanced midgut carcinoids underwent removal of the mesenteric tumor with a method for preserving the mesenteric vessels. This was feasible by mobilizing and releasing the right colon and mesenteric root from posterior adhesions, identifying the mesenteric artery below the pancreas, and free-dissecting this artery on the tumor capsule in the mobilized mesentery. Dissection was successful even with tumors initially judged inoperable unless tumor growth completely surrounded the mesenteric vessels or extended retroperitoneally. One patient was subjected to distal intestinal artery bypass. Symptom relief was been substantial and often of long duration after mesenteric tumor removal in patients who prior to surgery often had threatening intestinal ischemia. Patients with advanced midgut carcinoids may benefit markedly from dissectional removal of mesenteric tumors, which (conceivably better than conventional wedge resection) preserves the length of the remaining intestine.
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PMID:Method for dissection of mesenteric metastases in mid-gut carcinoid tumors. 1103 14

A 43-yr-old man presented to the clinic with abdominal pain, jaundice, nausea, and vomiting and weight loss over a 6-month period. Physical exam was unrevealing other than mild epigastric tenderness. A computed tomographic scan of the abdomen revealed a mass in the head of the pancreas, which was resected at laparotomy by a Whipple's procedure. The histology showed a biliary tract carcinoid tumor. The patient had normal hydroxy-indole-acetic acid (HIAA) levels throughout. There has been no evidence of disease or tumor recurrence at 3.5 yr of follow up.
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PMID:A case of biliary carcinoid presenting with pancreatitis and obstructive jaundice. 1105 79


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