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

Oriental cholangitis is a poorly understood syndrome consisting of intrahepatic pigment stone formation with chronically recurrent exacerbations and remissions. Endemic to Asia, it is being encountered more frequently in the United States due to increased immigration of asians. Twenty-one patients with oriental cholangitis (9 men and 12 women), 19 to 84 years of age, all of whom immigrated from asian countries, were treated between 1970 and 1983. All had histories of episodic abdominal pain, most with jaundice, chills, and fever. Laboratory results were nonspecific but frequently included leukocytosis and hyperbilirubinemia. All patients were operated on with 15 having cholecystectomy, common duct exploration, and a bilioenteric anastomosis. E. coli was cultured from specimens obtained from the biliary tracts of all patients, and 13 patients had more than one organism. Four patients had a previous history of parasitic infection, and four different patients had parasites identified in the biliary tract intraoperatively. Early recognition and appropriate operation will decrease morbidity and mortality.
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PMID:Oriental cholangitis. 637 37

Distal common bile duct stenosis was observed in 16 (9%) of 170 alcoholic patients admitted to a Veterans Administration Medical Center in the last five years. The following clinical and biochemical features were significantly more common (P less than 0.05) among the 16 patients with common bile duct stenosis than in 154 without: jaundice, cholangitis, hyperbilirubinemia, alkaline phosphatasemia, pancreatic calcification, and malabsorption. Surgical decompression of biliary tree was necessitated in 13 of 16 cases due to obstructive jaundice in seven, cholangitis in four, portal fibrosis in one, and persistent abdominal pain in one. The mean (+/- SE) time interval between initial serum alkaline phosphatase elevation and surgical intervention was 308 +/- 108 days. Liver histology in eight cases was remarkable for portal fibrosis in seven and biliary cirrhosis in one. These data suggest that distal common bile duct stenosis is a progressive lesion which is quite prevalent in patients with advanced pancreatic disease of alcoholic etiology.
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PMID:Prevalence and natural history of distal common bile duct stenosis in alcoholic pancreatitis. 647 79

Caroli's disease is a congenital disease of cystic or saccular dilatation of the intrahepatic bile ducts. There are two disease entities: a simple type and a periportal fibrosis type. Frequent complications with the simple type are recurrent cholangitis, liver abscess, intraductal lithiasis, abdominal pain, and fever that often lead to fatal sepsis. Development of portal hypertension and esophageal varices is usually a final feature of the periportal fibrosis type. Malignancies are also possible complications with Caroli's disease. During the recent 13 years, the author had experiences with eight patients with Caroli's disease of the simple type; six of these eight underwent hepatic resection: right lobectomy in two, left lobectomy in three, and left lateral segmentectomy in one. Other two patients died of sepsis and cholangiocellular carcinoma, respectively. All six patients with hepatic resections were relieved from the disabling symptoms after surgery and have had no recurrent hepatobiliary problems for 3 months to 13 years. Hepatic resection may be indicated for more patients than previously assumed in the treatment of Caroli's disease of the simple type.
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PMID:Successful treatment of Caroli's disease by hepatic resection. Report of six patients. 650 1

A Doberman with jaundice, hepatomegaly and cranial abdominal pain had evidence of centrilobular necrosis on liver biopsy. Therapy with fluids, ampicillin and rest resulted in recovery. A Collie hit by a car developed traumatic hepatopathy and myopathy. The animal recovered with rest as the only treatment. A mongrel with hepatic lymphosarcoma benefited from chemotherapy for 5 months before euthanasia was necessary. A cat became lethargic and anorectic 9 days after an oral dose of piperazine. Liver biopsy revealed fatty change, vacuolation and mononuclear infiltration. Supportive care with amoxicillin, fluids and a high caloric intake resulted in recovery. Laparotomy in a jaundiced, anorectic cat revealed an obstructed common bile duct. Cholecystoduodenostomy and supportive care resulted in recovery. A vomiting, lethargic, jaundiced cat had evidence of chronic cholangitis on liver biopsy. The animal recovered after treatment with amoxicillin, fluids, prednisolone and forced feeding.
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PMID:Management of liver disease in dogs and cats. 654 4

Monooctanoin, a cholesterol solvent, was infused into the biliary tracts of six high risk patients, in an attempt to dissolve retained stones. The infusion rate was constant, 5-10 ml/h. The mean age of the patients was 76 years. Associated medical conditions were primarily cardiac in nature. Duration of infusion averaged 6 days. In two patients, the stones were completely dissolved. One patient was reoperated despite the stones appearing smaller after 6 days of infusion. At surgery, no stones were found. Two patients in whom dissolution was unsuccessful underwent reoperation. In both, retrieved stones were composed of less than 5% cholesterol. Five of the six patients experienced at least one episode of mild abdominal pain and vomiting. None developed cholangitis, pancreatitis, or significant biochemical abnormalities. Two of the three who underwent reoperation tolerated it without difficulty. While mechanical extraction, when feasible, is still the treatment of choice for retained biliary stones, chemical dissolution should be attempted before undertaking reoperation.
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PMID:Monooctanoin dissolution of retained biliary stones in high risk patients. 663 69

Caroli's disease is a rare congenital disorder characterized by segmentary saccular dilatation of the intrahepatic bile ducts, which manifests itself clinically by cholangitis and bile stones. We report two cases of Caroli's disease in schoolgirls with clinical signs of recurrent abdominal pain associated with intermittent crises of cholestatic jaundice. Diagnosis was made by retrograde cholangiography in one patient and by intravenous cholangiography in the other.
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PMID:Caroli's disease in childhood: report of two new cases. 664 53

Two female adolescents with cystic fibrosis were investigated by endoscopic retrograde cholangiography for recurrent abdominal pain. The cholangiogram of 1 patient demonstrated multiple irregular filling defects throughout the biliary tree representing thickened bile and mucus as well as stones. The cholangiogram of the other case illustrated cystic dilatation of the intrahepatic bile ducts with intrahepatic cholelithiasis as well as extensive irregularities of the smaller proximal ductules secondary to recurrent cholangitis or focal biliary cirrhosis, or both. Endoscopic papillotomy resulted in drainage of tenacious bile and mucus and stones in both cases. Sustained clinical improvement did not follow papillotomy in either case, whereas radiologic improvement was demonstrated in 1 case.
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PMID:Biliary tree in cystic fibrosis. Biliary tract abnormalities in cystic fibrosis demonstrated by endoscopic retrograde cholangiography. 684 Apr 90

A 72-year-old man with choledocholithiasis, demonstrated radiologically, was treated by constant perfusion through the gallbladder of monooctanoin (glyceryl-1-monooctanoate) following cholecystostomy for a perforated gallbladder. The monooctanoin was given at a rate of 7.5 ml/h and monitored to ensure that delivery pressure did not rise above 20 cm H2O. Perfusion was carried out for 60 hours, but could not be continued because of abdominal pain, nausea and vomiting. This was followed by progressive jaundice, anorexia and fever. The patient was treated with penicillin G and cefoxitin intravenously and metronidazole orally, but he died 5 weeks after the perfusion. Autopsy showed acute pancreatitis and cholangitis, and a biliary tree filled with pus and a black biliary cast. No calculi were present. The authors consider the possible causes for this patient's death.
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PMID:Necrotizing choledochomalacia after use of monooctanoin to dissolve bile-duct stones. 713 18

In the Cape Town Children's Hospital ascariasis is the commonest cause for an acute abdominal emergency; over a thousand cases have been admitted with ascariasis to the paediatric surgical wards. There was a high incidence of biliary ascariasis (424 cases) and routine intravenous cholangiography should be performed in all children with abdominal pain where ascariasis is suspected. The normal host/parasite relationship is described and the frequent invasion of the ampulla of Vater by the worm is discussed. The typical worm biliary colic is described and the classical surgical findings reported. The radiographic, ultrasonic and duodenoscopic diagnoses of the disease are evaluated. The management of the patient is described. Ninety-five percent of them were uncomplicated cases, but in 20 or 5% of the patients complications arose, the most important of them being ascariasis cholangitis, pyogenic cholangitis, perforation of the bile duct, cholecystitis and pancreatitis. The diagnosis and surgical management of these complications are described in some detail.
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PMID:Biliary ascariasis in children. 714 48

Acute cholangitis, as a serious, sometimes life-threatening clinical picture, is often clearly distinguishable by virtue of its clinical symptomatology (fever, upper abdominal pain, possibly also jaundice). Chronic cholangitis, primary sclerosing cholangitis and chronic destructive, non-suppurative cholangitis are, although clearly defined, without symptoms in the early stages, and can be diagnosed only on the basis of long-term observations. Clinical symptomatology, diagnosis and differential diagnosis, therapy, course and prognosis are discussed.
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PMID:[Inflammatory biliary tract diseases]. 720 43


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