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)

A 63-year-old woman presented with progressive congestive heart failure and unexplained cardiomegaly. Diagnostic workup revealed large arteriovenous fistulae in the lower pole of the left kidney. A total left nephrectomy was performed and microscopic exam revealed renal cell carcinoma. Following surgery, the congestive heart failure cleared and the patient has been asymptomatic for one year. The pertinent findings of the 22 patients who have been reported previously in the literature with arteriovenous fistulae complicating renal cell carcinoma are reviewed. Thirty percent of the patients presented with cardiovascular complaints, and 60% had significant cardiovascular findings during the course of evaluation. An abdominal bruit was the most discriminating finding on physical exam, and it occurred in 72% of the reported cases. The diagnosis was unexpectedly established by surgery in 13%, and by angiography in 87% -- usually in the course of a workup for hypertension, abdominal pain, hematuria, or during search for an occult malignancy. An extensive evaluation is required for early diagnosis of this correctible cause of hypertension and heart failure.
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PMID:Arteriovenous fistulae secondary to renal cell carcinoma. Clinical and cardiovascular manifestations: report of a case. 12 58

We report on 3 patients who presented with an acute onset of abdominal pain, a palpable abdominal mass and a rapid decrease in hemoglobin. In 2 patients a spontaneously ruptured hypernephroma was found and the other patient had a squamous cell carcinoma of the ureter with bleeding into the tumor. Although in all 3 cases the tumors were at an advanced stage of development, the patients had been entirely free of urological symptoms until shortly before hospitalization. The importance of considering the possibility of spontaneous rupture of such a tumor in the evaluation of cases of an acute abdomen is stressed.
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PMID:Spontaneous rupture of renal and ureteral tumors presenting as acute abdominal condition. 50 31

A known complication of long-term hemodialysis, acquired cystic kidney disease (ACKD) has been reported infrequently in association with chronic ambulatory peritoneal dialysis (CAPD). The duration of end stage renal failure (ESRF) is thought to correlate with the development of ACKD. Renal cell carcinoma has been reported in 4-10% of patients with ACKD. Two patients on CAPD for more than 6 years without prior hemodialysis treatment developed renal malignancy in the setting of ACKD. Flank and abdominal pain was the presenting symptom in both patients neither of whom had hematuria. Renal ultrasound detected cystic lesions consistent with ACKD; malignant masses were ultimately identified by CT scan. Both patients underwent flank radical nephrectomy, resumed CAPD early in the postoperative period and continue on CAPD 9 and 4 months after surgery. One patient has since developed hepatic metastasis. ACKD is an important risk factor for the development of renal cell carcinoma not only in maintenance hemodialysis patients but also in the CAPD population. A high index of suspicion and serial ultrasound screening for ACKD is warranted in patients with long-term dialysis-dependence.
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PMID:Renal malignancy in peritoneal dialysis patients with acquired cystic kidney disease. 136 72

We report a case of renal cell carcinoma in a 6-year-old girl. The child had the chief complaints of gross hematuria and abdominal pain. An examination using ultrasound, computerized tomography scans and angiography showed a left renal tumor. Left side radical nephrectomy with lymphadenectomy was performed. Histopathological examination revealed renal cell carcinoma of clear cell type with metastasis to the hilar lymph node. She received postoperative therapy with interferon. Now, 3 years since the operation, she is living without evident recurrence. We reviewed 89 Japanese cases of renal cell carcinoma in children including this case and have discussed symptoms, differential diagnosis and treatments.
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PMID:[A case of renal cell carcinoma in childhood]. 141 59

The Cincinnati Transplant Tumor Registry recorded 169 cases of renal carcinoma developing in transplant recipients. The great majority of these cases were of primary renal cell carcinoma developing in the recipient native kidneys. Renal carcinoma developing de novo in the renal allograft occurred 17 times, with a maximal interval to clinical development of 85 months after transplantation. The development of multicentric renal cell carcinoma in an allograft 156 months after transplantation is described. The 24-year-old white male recipient with Alport's syndrome received a cadaver renal allograft from a healthy 27-year-old black man who had died of a cerebral hemorrhage in 1977. At 13 years after transplantation the recipient had upper abdominal pain. Ultrasound revealed 2 incidental renal masses and a renal cyst in the allograft. Partial nephrectomy confirmed the presence of multicentric renal carcinoma. The graft was left in situ and immunosuppression was maintained. The recipient continued to do well with no evidence of disease 1 year postoperatively. Deoxyribonucleic acid banding demonstrated that the tumor and recipient blood were of different patterns.
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PMID:Late development of renal carcinoma in allograft kidney. 163 45

Two cases of spontaneous rupture of the kidney are reported and the literature is reviewed. The clinical and pathological features of this uncommon disease and its treatment are discussed. In the first case the cause of retroperitoneal bleeding was a renal carcinoma, while in the second it was the result of renal metastases from gestational trophoblastic disease. The most common symptoms are an acute onset of flank or abdominal pain, macroscopic hematuria and a drop in the hemoglobin level. Resistance or a mass can be palpated. Ultrasound and radiological examinations allow visualization of a tumor or hematoma and mostly reveal the etiology of hemorrhage. An exploratory operation is necessary for diagnosis, and primary nephrectomy should be seriously considered.
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PMID:[Spontaneous kidney rupture]. 221

We report on 5 patients who presented with acute onset of abdominal pain, a palpable mass, and a rapid decrease in hemoglobin. All 5 patients had been entirely free of urological symptoms until shortly before hospitalization. Spontaneous rupture of a kidney with an underlying pathological condition was found in all cases. In 2 cases the underlying lesion was renal cell carcinoma, while in the other 3 cases the lesion was a renal angiomyolipoma, a polycystic kidney and hydronephrosis secondary to UPJ obstruction, respectively. The importance of considering the possibility of spontaneous rupture of the kidney in the evaluation of cases of an acute abdomen is stressed.
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PMID:Spontaneous rupture of the kidney: a cause of acute abdominal pain. Case report. 259 30

We treated 19 patients with progressive metastatic renal cell carcinoma with continuous infusion of 5-fluoro-2-deoxyuridine, 52 per cent of whom had previously received and failed chemotherapy. Implantable pumps were used for automatic drug delivery. 5-Fluoro-2-deoxyuridine was infused continuously for 14 days at monthly intervals. The starting dose was 0.15 mg. per kg. per day (intravenous) or 0.25 mg. per kg. per day (intra-arterial). Intravenous doses were increased or decreased in increments of 0.025 mg. per kg. per day as permitted by toxicity. Abdominal pain, diarrhea and mucositis limited the intravenous infusion, while malaise, anorexia and hepatic function abnormalities limited intra-arterial infusion. Of 18 evaluable patients we observed 1 complete, 4 partial (objective response rate 28 per cent) and 2 minor responses. The duration of response ranged from 2 to greater than 18 months. During a median follow up of 7.5 months (range 2 to 21 months) only 4 of the 18 patients had objective tumor progression. Over-all survival for the 19 patients was 94 per cent. Continuous infusion of 5-fluoro-2-deoxyuridine may be effective for the treatment of progressive renal cell carcinoma.
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PMID:Progressive metastatic renal cell carcinoma controlled by continuous 5-fluoro-2-deoxyuridine infusion. 296 42

A patient with eight years' history of haemodialysis treatment developed gross haematuria. During evaluation severe abdominal pain with dyspnoea developed and he died suddenly. Autopsy revealed spindle cell type renal cell carcinoma (RCC) associated with acquired renal cystic disease and adenoma in the remaining kidney. Multiple embolization of RCC was considered to be linked to the cause of death. Although patients on long-term haemodialysis often have multiple renal cystic lesions, some of which are associated with tumour formation, RCC of this specific cell type in dialysed kidney has not been previously described.
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PMID:Renal cell carcinoma associated with acquired renal cystic disease. 317 Jan 4

Clinical, CT, and pathologic findings were analyzed in six patients with spontaneous subcapsular or perinephric hematomas complicating end-stage kidney disease. Renal failure had been managed by hemodialysis in four patients, by renal transplantation in one, and by conservative methods in one. All patients had nonspecific abdominal pain. CT clearly showed in all cases that the pain resulted from hemorrhage and also revealed the extent and location of hematomas. In addition, in four patients, CT showed underlying acquired cystic kidney disease that was the probable cause of hemorrhage. In one of these patients, CT also showed a renal cell carcinoma in the opposite kidney. Other causes for renal hemorrhage encountered in the series included renal infarction due to small vessel disease, heparinization during hemodialysis, and thrombocytopenia. Abdominal CT is a useful technique for evaluating patients with end-stage renal disease who have abdominal pain or who exhibit clinical evidence of blood loss.
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PMID:Spontaneous subcapsular and perinephric hemorrhage in end-stage kidney disease: clinical and CT findings. 349 60


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