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

Serial changes in thyroid hormone levels are described in two patients in whom hyperthyroidism was associated with transient non-thyroidal illness. In a 74-year-old woman with mild hyperthyroidism, two episodes of cholecystitis were associated with subnormal concentrations of serum T3 and increased concentrations of serum rT3; T3 became elevated during recovery, associated with a simultaneous fall in rT3. The TSH response to TRH was undetectable on three occasions. A cholecystectomy was performed after preparation with Lugol's iodine and subsequent tests showed evolution through T3 toxicosis to classical hyperthyroidism. In the second case, symptoms and signs of classical hyperthyroidism were noted during an undiagnosed illness characterized by severe abdominal pain and fever. Six days after the onset of this illness, an elevated level of serum T4 was associated with a normal total T3 concentration and increased concentration of rT3. After resolution of abdominal symptoms, serum T3 was markedly increased, associated with persistent T4 and rT3 excess. These findings indicate that the changes in T3 and reverse T3 described in non-thyroidal illness also occur in hyperthyroid patients, and suggest that the fall in T3 may be of sufficient magnitude to make T3 measurement diagnostically unreliable in the presence of non-thyroidal illness.
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PMID:Hyperthyroidism without triiodothyronine excess: an effect of severe non-thyroidal illness. 10 56

A series of 17 cases of gallstones in children observed over a period of 10 years in the area of Marseilles is described and the literature reviewed. The majority of children were girls over 10 years old. Symptoms were constantly present and the disease revealed nine times by acute "mechanical" cholecystitis, compared to 16 infectious cholecystitis followed during the same period, three times by an accident of migration (cholangitis in a 14 years old girl, bile ascitis in two infants). A cholecystography should be performed in acute recurrent abdominal pain of unknown origin in children, gallstones appearing to be radiotransparent in six patients. Among causes of gallstone formation, the authors dig out only 6 hemolytic anemias, related to hemoglobinopathies in three patients, and they emphasize the frequency of idiopathic cholelithiasis which should lead to a more complete investigation of the enterohepatic cycle and chemical constitution of bile in such patients.
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PMID:[A clinical survey on 17 cases of cholelithiasis in childhood (author's transl)]. 22 Jul 27

Cholescintigraphy, ultrasonography, and contrast cholangiography were compared in 60 patients. Among those having abdominal pain but no biliary disease or jaundice, cholescintigraphy was normal in 14/14, ultrasound in 10/13, and cholangiography in 13/14. Jaundice due to hepatocellular disease was correctly distinguished from complete biliary obstruction by cholescintigraphy in 17/17 patients and by ultrasound in 14/17. In cholelithiasis, ultrasound was abnormal in 10/12 and cholangiography in 7/9. Cholescintigraphy appeared most sensitive to active cholecystitis; only cholangiography and ultrasound visualized gallstones.
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PMID:Evaluation of hepatobiliary imaging by radionuclide scintigraphy, ultrasonography, and contrast cholangiography. 50 61

Choledochal cysts are being recognized with an increasing frequency among the adult population. In this series a correct preoperative diagnosis was established in eight of the ten patients. The clinical tirad of obstructive jaundice, right upper abdominal pain, and a palpable flactuant mass was noted in only two cases but at least one of these symptoms was present in all patients. Acute pancreatitis, cholecystitis, and biliary calculi were the commonly associated findings. New etiologic and clinical concepts of choledochal cysts are reviewed and the spectrum of radiographic features in adults is presented.
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PMID:Choledochal cyst in adults. A clinical and radiological study in ten cases. 61 81

We have studied three children with Wilson disease who had clinical symptoms suggestive of cholecystitis as well as radiologic evidence of gallstones, subsequently proven at the time of laparotomy. The gallstones from the patients with Wilson disease had an appreciably higher content of cholesterol than gallstones from age-matched children with hemolytic disease. Since gallstones may be present for years before they produce clinical symptoms, young patients with Wilson disease should undergo routine investigation for the presence of stones; cholelithiasis should also be considered in the differential diagnosis of abdominal pain in such patients.
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PMID:Cholelithiasis and Wilson disease. 62 3

The purpose of this investigation was to determine the diagnostic value (validity) of technetium-99m-pyridoxylideneglutamate cholescintigraphy (99mTc-PGC) in patients with and without cholecystitis and to compare its validity to those of oral cholecystography (OC) and ultrasonography (US). 99mTc-PGC was applied to 50 patients with acute, subacute, and/or chronic cholecystitis with cystic duct obstruction proven histologically and operatively, and also to 27 non-diseased volunteers and 43 patients with right upper quadrant abdominal pain who subsequently were proven free of gallbladder disease. In addition, 38 patients had OC, and 31 had US performed. The results shows that the sensitivity and specificity of 99mTc-PGC were 100%. Whereas for OC the sensitivity was 87%, specificity was 100%. For US the sensitivity was 70%, and specificity was 93%. The repeatability of 99mTc-PGC, OC, and US were 100%, 97% and 81% respectively. These data show that 99mTc-pyridoxylideneglutamate cholescintigraphy is a valid diagnostic tool in the evaluation of patients with cholecystitis, and is also safe and simple.
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PMID:The validity of 99mTc-pyridoxylideneglutamate (P.G.) cholescintigraphy as a diagnostic test for cholecystitis. 65 80

Actinomycosis of the gallbladder is rare, and the pathogenesis of the infection is poorly understood. The authors report the case of a 77-year-old man admitted to hospital because of abdominal pain. Clinical and laboratory findings suggested the diagnosis of cholecystitis and cholelithiasis. At cholecystectomy the gallbladder was inflamed and contained many calculi. Gram staining of material from the mucosa of the gallbladder demonstrated gram-positive pleomorphic filaments, and Actinomyces israelii grew in pure culture, thus confirming the diagnosis of actinomycosis of the gallbladder. The pathogenesis of the condition is also discussed.
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PMID:Actinomycosis of the gallbladder. 84

A case of sickle cell (HbSS) disease is presented in a patient with a history of recurrent admissions for abdominal pain, jaundice, and abnormal liver function tests. Although he was believed to have a sickle cell abdominal crisis, his abdominal X-ray films revealed three calcified stones. Each of these stones progressively passed through the common duct and into the duodenum while awaiting surgery. He has been followed for two years since his cholecystectomy without further hospitalizations. This case led to the investigation of cholelithiasis in sickle cell disease to dispel the following misconceptions. Some physicians and pediatricians believe that (1) cholelithiasis and cholecystitis are uncommon in sickle cell disease; (2) the complications of gallstones are not significant; (3) the operative risk in patients with sickle cell disease is high; (4) these patients with HbSS disease do not live long enough to get into trouble with gallstones. A review of the literature on cholelithiasis and HbSS disease presents adequate evidence to cause us to urge investigation of the gallbladder in all patients with HbSS disease and abdominal crises, and cholecystectomy as an elective procedure should stones be present.
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PMID:Cholecystitis and cholelithiasis masking as abdominal crises in sickle cell disease. 95 Nov 41

Seventy-nine patients, twenty years old or younger, with cholecystitis underwent cholecystectomy during a five year period at Santa Rosa Medical Center. There was a considerable delay in diagnosis in many cases. Etiologic factors differed with race and age; however, the disease appears to be quite similar in adolescents and adults. Hemolytic disease was present in all five blacks but in none of the remaining seventy-four patients. Patients younger than ten years of age are more likely to have congenital anomalies or infectious etiologies for the gallbladder disease. Cholecystectomy was associated with minimal morbidity and no mortality in this series. Cholecystitis should be considered early in the child or adolescent with unexplained abdominal pain, and oral cholecystograms proved to be a safe and reliable method of diagnosis.
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PMID:Gallbladder disease in children and adolescents. 95 32

A somewhat obese, 40-year old female presented with a classic history of gallbladder disease and a peripheral eosinophilia of 14% without an allergic history. A nonvisualizing oral cholecystogram was followed by an uneventful cholecystectomy. Pathological examination revealed a calculus in the cystic duct and a pure transmural eosinophilic infiltrate of the gallbladder wall. Postoperatively the peripheral eosinophilia returned to normal. Biopsies of the small bowel one year later showed focal mucosal eosinophilia when the patient had recurrent abdominal pain, diarrhea and peripheral eosinophilia. Eosinophilic cholecystitis may represent a descrete entity in search of an etiology or involvement of the biliary tract by eosinophilic gastroenteritis.
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PMID:Eosinophilic cholecystitis. 99 96


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