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

Six autopsy cases of the rare, diffuse type of hepatocellular carcinoma (HCC), as classified gross anatomically according to the strict definition, have been studied. The prominent clinical feature was the rapid deterioration of the patient's general condition, terminating in hepatic failure. The liver size enlarged quickly, at a perceptible speed, often accompanied by abdominal pain. Diagnosis of this particular type of HCC was difficult, and celiac angiography and scintiscan of the liver were only suggestive when considered together with other laboratory data. Hepatitis B surface antigen was positive in all three patients in whom it was tested. The entire liver was studded with minute, uniformly sized tumor nodules, evenly distributed throughout. Some of them were grossly indistinguishable from cirrhotic nodules. All livers had an underlying cirrhosis which was characterized by relatively small regenerative nodules with thin stromas. Large portal branches at the hilum contained tumor thrombi in all patients, except for one case in which left lobectomy was followed by intraportal dissemination. Histologically, all tumor nodules represented intrahepatic metastases via the portal vein system. Tumor cells were poorly differentiated. These findings suggest that the diffuse type of HCC most frequently, if not always, represents intrahepatic, widespread portal metastases which have occurred within a short period of time.
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PMID:A clinical and pathological study of diffuse type hepatocellular carcinoma. 629 41

A 66-year-old man was admitted because of right lower abdominal pain and was operated on for acute appendicitis on March 12, 1983. It was found that his appendix was not inflamed, but a bleeding tumor was encountered in the posterior segment of the liver. Bleeding was controlled by suturing the liver above the tumor. Postoperative celiac angiography revealed many daughter tumors scattered in, but restricted to, the right lobe of the liver. The patient was treated by transcatheter arterial embolization combined with transcatheter arterial infusion of lipiodol and Adriamycin on April 25. Subsequently, a curative operation (right hemihepatectomy) was performed on May 24. The patient is still alive without recurrence 6 months after the resection. In case of ruptured hepatocellular carcinoma, it appears to be better to perform a two-stage operation with careful estimation of functional reserve of the liver, and to conduct transcatheter arterial embolization between operations to prevent the growth of the tumor during that period.
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PMID:[A case of hepatocellular carcinoma (acute abdominal type) misdiagnosed as acute appendicitis and satisfactorily treated by a two-stage operation]. 633 25

Fifty-six patients with chronic intestinal ischemia underwent surgical revascularization. All patients had abdominal pain, 98% experienced significant weight loss, and 75% had an abdominal bruit. Visceral artery occlusive disease was documented by angiography in all patients; 77% of our patients had multiple-vessel occlusive disease, and 23% had single-vessel involvement of either the celiac or the superior mesenteric artery. The mortality rate was 8.9%. Ninety-six percent of the survivors were completely relief of symptoms, but an overall late recurrence rate was noted in 26.5%. Fifty-nine percent of our patients underwent revascularization of all stenotic vessels. Complete revascularization in multiple-vessel disease resulted in a late recurrence rate of 11%. When two of three stenotic vessels were revascularized, there was a 29% recurrence rate, and when one of three stenotic vessels was revascularized, there was a 50% recurrence rate. These findings suggest that although single-vessel revascularization may relieve symptoms, the optimal long-term result can be obtained by complete revascularization of all stenotic vessels.
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PMID:Surgical management of chronic intestinal ischemia: a reappraisal. 645 13

Celiac artery compression syndrome has been referred to in the literature as an entity in limbo, yet there have been many cases that have been well documented. This report describes two cases of abdominal pain with epigastric bruits in which the diagnosis of celiac artery stenosis was made. The abdominal bruit with its diastolic component had been the "tip-off" in both of these patients. Both patients did poorly with conservative treatment and eventually required surgical decompression.
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PMID:Celiac artery compression syndrome. 669 55

A young man with severe abdominal pain and weight loss due to intestinal ischemia was examined. At operation, the origins of the celiac and superior mesenteric arteries were found to be compressed by plexiform neurofibromatosis. Symptoms were relieved by reconstructive arterial surgery.
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PMID:Abdominal angina and neurofibromatosis. 679 34

A 48-yr-old woman with chronic intestinal ischemia and a long history of oral contraceptive use is reported. She presented with a 6-month history of severe diarrhea, abdominal pain, and weight loss. Abdominal arteriography revealed occlusion of the celiac axis at its origin and 90% stenosis of the superior mesenteric artery. This chronic arterial lesion has not been previously noted in association with the use of oral contraceptive agents in otherwise healthy women. The patient's isolated arterial lesions proved amenable to successful surgical bypass. Postoperatively she became completely asymptomatic and has remained so on long-term follow-up.
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PMID:Chronic intestinal ischemia associated with oral contraceptive use. 706 61

The association of cavernous hemangioma, focal nodular hyperplasia, and hemangiomatosis of the liver has not previously been described in the literature. A case report of a patient who presented with these 3 lesions simultaneously is reviewed. The 32-year-old obese woman presented with upper abdominal pain of recent onset. No liver abnormality had been noted at the times of cholecystectomy and cesarean section, each performed some years before. She had taken oral contraceptives (OCs) 6 years earlier for about 6 months. Now the liver was enlarged and contained a firm, nontender mass that extended to 1 handsbreadth below the right costal margin and across the epigastrium. No bruit was noted. Results of hematologic and biochemical investigations were within normal limits. Ultrasonography revealed a solic mass, and selective celiac arteriography showed that the mass occupied the right lobe of the liver and was predominantly avascular, with small areas of pooling of contrast material. An operation revealed, in addition to the mass, many irregular purplish areas 2-4 mm in diameter in both lobes of the liver. Close to the free edge of the left lobe was a yellowish brown and slightly modular firm mass. The pathological report listed a giant cavernous hemangioma of the right lobe, several disseminated cavernous hemangiomata, multiple disseminated vascular ectasiae (hemangiomatosis) and 1 lesion of focal nodular hyperplasia in the left lobe. 27 days after the operation, scintiscanning revealed evidence of good liver regeneration. Another scan 3 years later revealed regeneration of the liver to normal size and no focal abnormalities. Due to the fact that increasing numbers of cases of focal nodular hyperplasia and liver cell adenomas have been reported in association with OCs and in view of the possible association between these drugs and hemangioma, caution in prescribing these drugs is recommended.
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PMID:Liver lesions and oral contraceptives. 707 31

This is the first comprehensive report of coeliac disease from South Africa. Twenty patients with adult coeliac disease diagnosed in Johannesburg between 1966 and 1978 are reviewed. It is noted that a significant number did not present with the classic features of the disease. Secondary nutritional manifestations were frequently absent, and may have been masked in some patients by self-medication or by the prescription of vitamins and haematinics before the diagnosis was made. The majority of patients were from the middle or upper socio-economic class, and few complained of anorexia, nausea, vomiting or abdominal pain. It is therefore possible that many maintained an adequate intake of nutrients throughout the course of their illness. The severity of diarrhoea and steatorrhoea did not correlate with the state of nutrition of the patients as assessed by a variety of blood studies. Megacolon, present in 2 patients, responded to a gluten-free diet. An interesting observation was that patients diagnosed after the age of 40 years had been symptomatic for a much shorter period of time than younger patients.
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PMID:Adult coeliac disease in South Africa. An analysis of 20 cases emphasizing atypical presentations. 722 82

The article describes 20 patients with complicated duodenal ulcers and 50 patients with chronic abdominal pain syndrome who had inflammatory-sclerotic alterations of elements of the celiac plexus and the arcuate ligament of the diaphragm accompanied in certain cases by compression stenosis of the celiac trunk. Patients with duodenal ulcers were subjected to desympathization and decompression of the celiac trunk in combination with proximal selective vagotomy and drainage of the stomach in cases of stenosis. The postoperative period was found to be favourable, without disturbed gastric evacuation. Good remote results were observed in 8 patients within one year and in 4 patients within 2 years after the operation.
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PMID:[Sympathectomy and decompression of the celiac trunk in combination with proximal selective vagotomy in surgical treatment of duodenal ulcer complications]. 722 17

Fifteen patients were operated on for compression of the celiac artery with division of the median arcuate ligament. Initially most patients were released from their preoperative abdominal pain. At follow-up after 1 1/2-9 1/2 years only two patients were asymptomatic. Our results corroborate the nonentity of the celiac compression syndrome. The existence and identification of a subgroup of patients with symptomatic compression of the celiac artery is discussed.
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PMID:The celiac compression syndrome: myth or reality? 733 58


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