Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Choledochal cyst was diagnosed before operation in 14 out of 16 infants and children by means of a combination of diagnostic tests. Ultrasonic echogram showed a cystic mass in all 11 patients examined. The characteristic displacement of the duodenum was noted in 9 of 14 patients by contrast studies of the upper gastrointestinal tract, and hepatobiliary scintiscanning confirmed choledochal cyst in 7 of 8 patients (88%). A cyst was shown by oral or intravenous cholangiography in 3 of 4 patients. Onset of symptoms occurred from 7 days of age to 9-5 years; in 10 patients onset occurred under 12 months of age, in 3 from 13 to 24 months, and in the remaining 3 from 2 to 9-5 years. The first symptoms were jaundice, vomiting, acholic stools, and poor sucking. Obstructive jaundice and acholic stools were found in more than 80% of the patients, and abdominal mass in 60%. Vomiting occurred in 50% of the patients, one-third of whom showed failure to thrive, and 70% of patients over the age of 1-5 years had abdominal pain. About half of the patients had a mild to moderate degree of fever. In all patients primary excision of the cyst was followed by hepaticojejunostomy in Roux-en-Y fashion. The postoperative course was uneventful in 14 patients; 2 patients died, one from ascending cholangitis and one from hepatic failure.
 ...
PMID:Choledochal cyst in infancy and childhood. Analysis of 16 cases. 83 63

Choledochal cyst remains a rare pathology in western countries. Over the past 15 years, 18 children were diagnosed with choledochal cyst at Hospital Sainte-Justine. There were 14 girls and 4 boys with an average age of 7.4 years ranging from newborn to 15 years. Abdominal pain, jaundice and abdominal mass were present in 70%, 54% and 7% respectively. Only one patient, a 15 years old girl had all three symptoms. Abdominal ultrasonography was diagnostic in all cases and in two cases, a cystic dilatation was found in the antenatal ultrasonography. Transvesicular cholangiography was performed successfully in 11 patients and showed a detailed anatomy of the biliary tract preoperatively. Sixty-seven percent of the cysts were type I while 33% were type IV. A common channel was found in 43% of the cases. Sixteen patients underwent cyst excision followed by Roux en Y hepatico-jejunostomy, one patient with associated biliary atresia had a porto-enterostomy and one patient had a cysto-duodenostomy. The last patient had recurrent episodes of cholangitis and required reoperation while the others are doing well and free of infection. With the liberal use of ultrasonography, the diagnosis of choledochal cyst is being done earlier improving the long term prognosis. Transvesicular cholangiography is a very useful addition in the preoperative investigation of these patients. Roux en Y hepatico-jejunostomy was associated with minimal morbidity and mortality and gave excellent result.
 ...
PMID:[Cysts of the choledochus in children: experience of the Sainte-Justine hospital]. 129 61

Choledochal cyst is an uncommon congenital lesion of the pancreatobiliary system. The pathologic features are cystic dilatation of the common bile duct, normal liver parenchyma, a normal intrahepatic biliary system and partial obstruction of the terminal common bile duct. More than 1400 cases have been reported in tre literature, 83 per cent of which have been diagnosed in patients below the age of 30. A triad of abdominal pain, jaundice and a palpable abdominal mass in the right hypocondrium has been classically associated with this condition. Ultrasonography and CT scanning are usually successful in demonstrating the mass. Cholangiography by the endoscopic retrograde approach may demonstrate the cystic dilatation of the common bile duct. The precise relation ship of the cyst to the biliary tree should be demonstrated by cholangiography at operation. The common type I fusiform cyst is currently treated either by excision combined with a biliary intestinal anastomosis of by anastomosis of the cyst to the intestinal tract. Treatment of the rare type II diverticulum consist of simple excision, while the rare type III choledococele is treated by transduodenal excision of the cyst wall. The current mortality rate of choledochal cyst treated by surgical decompression is 5 to 10 per cent. A case of choledochal cyst in a 58 years old woman is described. The anatomopathologic, clinic features and therapeutic lines are pointed out.
 ...
PMID:[Cystic dilatation of the choledocus]. 343 33

Patients with choledochal cyst often have repeated attacks of abdominal pain accompanied by hyperamylasemia, and they may be diagnosed as having acute pancreatitis. However, the attacks generally tend to subside in a short period by conservative treatment, and evidence of pancreatitis is rarely observed at the time of surgery. Choledochal cyst is commonly associated with pancreatobiliary maljunction, and high concentrations of pancreatic enzymes in bile are usually observed. When the bile duct pressure increases due to obstructive cholangitis, pancreatic enzymes in bile may regurgitate into the blood stream. Cholangiovenous reflux of amylase might cause hyperamylasemia. In order to investigate the mechanism of hyperamylasemia by cholangiovenous reflux, canine pancreatic juice or bile from a patient with choledochal cyst was injected into the obstructed common bile duct in dogs. The pancreatic enzymes in bile could readily enter into the blood stream at the pressure level of 15 mmHg or more in the bile duct. The peak amylase level in the thoracic lymph was observed to be more than 4 times higher than that in the blood serum, and the lymph flow during 30 minutes increased significantly from 8.1 to 20.4 ml at the bile duct pressure level of 20 mmHg. The reflux of amylase in bile into the blood stream via both the hepatic vein and thoracic duct might result in hyperamylasemia in the patients with choledochal cyst.
 ...
PMID:Does hyperamylasemia in choledochal cyst indicate true pancreatitis? An experimental study. 754 97

Choledochal cyst in an uncommon congenital anomaly with classic presentation triad of abdominal pain, jaundice and right upper abdominal mass. Presentation due to biliary peritonitis following cyst rupture is extremely rare. One such case which was successfully treated is being reported.
 ...
PMID:Spontaneous rupture of choledochal cyst. 1083 44

There is a remarkable diversity of conditions encompassed by benign liver masses in infants and toddlers. The most common benign hepatic tumor in this age group is infantile hepatic hemangioendothelioma. Other commonly seen benign tumors are mesenchymal hamartoma and focal nodular hyperplasia. Hepatic adenoma is almost exclusively a disease of older children; primary hepatic teratoma is exceedingly rare. There are several distinguishing characteristics of these benign tumors on radiographic evaluation; however, imaging techniques such as ultrasound scan, computed tomography, and angiography are not always reliable in differentiating benign from malignant tumors. The differential diagnosis of benign hepatic tumors includes nonneoplastic cystic masses including biliary and simple hepatic cysts, hematoma, parasitic cysts, and pyogenic and amebic liver abscess. Choledochal cyst presents with a classic triad of abdominal pain, cholestatic jaundice, and a palpable abdominal mass. They are classified anatomically into 5 subtypes with the most popular types being type I and type IV. Treatment is with complete cyst excision with hepaticojejunostomy reconstruction.
 ...
PMID:Benign liver and biliary tract masses in infants and toddlers. 1094 25

BACKGROUND: Choledochal cyst is a rare abnormality usually found in infancy and childhood and mainly in females. Outcome depends on early diagnosis, complete resection of the cyst and proper hepaticoenterostomy.OBJECTIVE: The aim of this paper is to evaluate the outcome of 18 patients operated in ten years. METHODS: Retrospective chart review. RESULTS AND DISCUSSION: Age ranged between 20 days and 13 years (mean 3 years). Fifteen (83%) were female and 03 (17%) male. Signs presented included 15 (83%) with jaundice, 11 (61%) with dark urine, 10(55%) with pale colored stools, 09 (50%) with abdominal pain and palpable mass in only 02(11%). Ultrasonography identified the cyst in 14 (77%) patients. Endoscopic retrograde cholangio-pancreatography demonstrated a long common duct in three of four cases. Anatomical types were: 09 type I, 01 type II, 07 type IV and 01 type V. Except for one patient who had a type V cyst, all patients underwent cyst resection plus Roux-en-Y hepaticojejunostomy. There were two (11%) early postoperative deaths related to deterioration of liver function. Thirteen (86%) of the 15 patients available to follow-up were symptom-free without late complications at a mean period of three years, and two (14%) patients developed chronic pancreatitis.
 ...
PMID:[Choledochal cyst: a 10-year experience] 1464 88

Choledochal cyst is a relatively uncommon entity in Western countries. No reports of choledochal cyst in heart transplant patients have been reported to date. We report two cases of choledochal cyst in pediatric heart transplant recipients, one with post-transplant lymphoproliferative disorder (PTLD) within the cyst. The first patient had abdominal pain, increased liver enzymes and was seropositve for Epstein-Barr virus. A choledochal cyst with PTLD was removed 4 years after heart transplantation. The second patient presented 14 years after heart transplantation with a choledochal cyst that was excised for severe abdominal pain. This previously unreported association between choledochal cysts in conjunction with PTLD and heart transplantation is interesting and a possible common pathogenesis is proposed. The management and alternative treatments were briefly noted. We recommend an aggressive treatment for patients with suspected choledochal cyst after heart transplantation because of the increased potential for malignant transformation.
 ...
PMID:Choledochal cyst in two pediatric heart transplant patients. 1899 56

Choledochal cyst, usually recognized as a problem in infants, is increasingly reported in adult patients. The aim of this study was to share our experience in treating adult patients with choledochal cysts. Two hundred twenty-one adult patients with choledochal cysts who were treated in our hospital from January 2002 to December 2010 were enrolled. The clinical data were retrospectively collected and analyzed. There were 168 Type I, three Type II, three Type III, 26 Type IV, and 21 Type V cysts. The presentations were nonspecific with 177 patients having abdominal pain and a few patients having other rare symptoms including back pain, cirrhosis, occupying lesions, or spontaneous rupture. The cysts were completely removed in 169 patients, and 36 patients required liver resection. There was one death resulting from abdominal bleeding. Morbidity was limited to 27 patients, 11 of whom underwent invasive interventions. Choledochal cysts remain an interesting clinical problem. In some adult cases, the diagnosis is very difficult. Treatment is type-dependent, complete removal of the cysts is widely accepted, and lifelong follow-up for these patients is recommended.
 ...
PMID:Clinical analysis of 221 cases of adult choledochal cysts. 2247 97

Choledochal cyst is a rare condition characterised by congenital dilatation of the biliary tree. Commonly seen in the oriental countries, patients usually present with a varying combination of abdominal pain, jaundice, lump or cholangitis. Untreated patients or incomplete removal of the cysts usually leads to portal hypertension and cholangiocarcinoma. Almost one-third of the cases have intrahepatic cyst, making complete cyst excision often impossible. We are reporting a 9-year-old girl with type IVa choledochal cyst presented to us with recurrent pain abdomen and intermittent jaundice for 1 year. Excision of extrahepatic cyst, left hepatectomy, mucosectomy of the residual cyst wall of right lobe of the liver and a wide bilioenteric anastomosis was done. Patients followed up with an magnetic resonance cholangiopancreatography (MRCP) 2 months later showed shrinkage of the residual cyst and good bile drainage. Mucosectomy of intrahepatic cyst may prevent recurrent cholangitis, calculus formation and cholangiocarcinoma in the long run.
 ...
PMID:Type IVa choledochal cyst: Results following haemihepatectomy and mucosectomy of intrahepatic cyst. 2313 6


1 2 Next >>